Evolutional neurologic evaluation of seven year-old children born prematurely

Abstract

-A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.KEY WORDS: prematurely born children, development, evolutional neurologic evaluation. Avaliação neurológica evolutiva aos sete anos de idade de crianças nascidas prematurasRESUMO -Para estudar o desenvolvimento neuropsicomotor em amostra de prematuros aos 7 anos de idade, foram avaliadas 51 crianças prematuras e comparadas com 44 a termo. O grupo de prematuros tinha idade gestacional de até 37 semanas e 6 dias e peso de nascimento até 2500g. O grupo controle foi constituído de crianças com idade gestacional entre 38 e 42 semanas e acima de 2500g. Os instrumentos de avaliação utilizados foram os exames clinico, neurológico e neurológico evolutivo (ENE). Os resultados mostraram que impulsividade, agressividade, desorganização e enurese foram sintomas prevalentes nos prematuros. As alterações no exame neurológico não discriminaram os grupos, embora paralisia cerebral só tenha ocorrido nos prematuros. As funções do ENE que distinguiram os grupos foram equilíbrio dinâmico, coordenação tronco-membros e persistência motora, constituindo-se esta no comprometimento dominante nos prematuros e as alterações na coordenação tronco-membros em achado peculiar neste grupo. PALAVRAS-CHAVE: prematuridade, desenvolvimento neuropsicomotor, exame neurológico evolutivo.It has been well established that the development of the central nervous system (CNS) begins at conception and continues to adulthood. Psychomotor development has also been observed during intrauterine life 22 . CNS development is achieved through a series of transformations. An early phase of neuronal proliferation that occurs between the second and fourth month of gestation involves neurons and glial cells derived from the ventricular and sub-ventricular zones. During a second phase of neuronal migration, between the third and fifth month of gestation, millions of neurons move from their original site to their final locations. A third phase involves the organization that begins around the sixth month of gestation and persists for several years. Lastly, the final phase of neuronal maturation is related to the myeli...

Association between the frequency of bedwetting and late preterm birth in children aged ≥5 years

“…However, in this study, among patients with NE, 41 out of 544 (7.5%) were born prematurely, and 77 (14.2%) of 544 were born with a low BW. These demographic data show similar prevalence rates to those previously reported . Taken together, it can be considered to show a general tendency in the proportion of enuresis patients who were born prematurely.…”

“…Even decades ago, although premature birth was never specifically considered as the primary cause of NE, several studies have reported the association between BW and NE recently . A retrospective cohort study conducted in the United States showed that a low BW carries an increased risk of prolonged bedwetting .…”

“…Importantly, NE is known to negatively affect the child's psychosocial status, such as declining self‐esteem, and to be associated with a range of psychological or behavioural problems, such as attention‐deficit/hyperactivity disorder (ADHD) . Several epidemiological surveys have been undertaken to determine the perinatal factors associated with NE; however, conflicting findings regarding the relevance of birthweight (BW) on NE have been reported, whereby NE has been shown to be associated with low BW (defined as <2500 g) in some studies and unrelated in others . Furthermore, little information is available regarding the relationship between NE and gestational age, especially late preterm (LPT) birth.…”

Parachute and lateral propping reactions in preterm children

“…The evolutional neurological evaluation (ENE) at 7 years of age in a group of preterms showed a statistically significant alteration in trunk-limb coordination in relation to term children 10 ; other studies assessing school-age children born at term have also observed unaltered trunk-limb coordination 11,12 . Our work aimed at verifying whether alterations in trunk-limb coordination can be observed in the 1st year of life in preterm children.…”