Risk factors associated with developmental abnormalities among high-risk children attended at a multidisciplinary clinic

Abstract

CONTEXT AND OBJECTIVE: Knowledge of risk factors associated with child development disorders is essential for delivering high-quality childcare. The objective here was to evaluate the relationships between risk factors and occurrences of developmental abnormalities among children attended at a reference clinic for children at risk of developmental abnormalities. DESIGN AND SETTING: Retrospective study at a multidisciplinary reference center, Embu, São Paulo. METHODS: All cases followed up for more than three months between 1995 and 2003 were reviewed. The risk factors assessed were low birth weight, gestational age, length of stay in neonatal ward, perinatal asphyxia, mother’s age < 18 years, congenital infections, malformations and low mother’s education level. Developmental abnormalities were defined according to developmental tests and assessments by the clinic’s professionals. The statistical analysis consisted of the chi-squared test for comparing categorical variables and a logistic regression model for multivariate analysis. RESULTS: 211 children were followed up for more than three months. Developmental abnormalities occurred in 111 (52.6%). Univariate analysis showed significant relationships between developmental abnormality and low birth weight, perinatal asphyxia, length of stay > 5 days, prematurity and mother’s age 18 years and older. Low birth weight, history of perinatal asphyxia and mother’s age continued to be significant in multivariate analysis. CONCLUSIONS: Special attention must be paid to the development of low birth weight infants and/or infants with histories of neonatal complications. Low birth weight is easily assessed and should be considered to be an important marker when defining guidelines for following up child development.

Desenvolvimento cognitivo e linguagem em prematuros

“…Scientific advances emphasize that cerebral plasticity is more marked in the first years of age. It is susceptible to stimulation as well as to biological, genetic, and environmental factors (13,14) . Children who present alterations in their development and obtain early diagnosis and interventions will have higher progress possibilities (14,15) .…”

“…It is susceptible to stimulation as well as to biological, genetic, and environmental factors (13,14) . Children who present alterations in their development and obtain early diagnosis and interventions will have higher progress possibilities (14,15) . However, when following preterm infants, it is necessary to correct the age with the aim of identifying possible development delays or deviations.…”

Saúde da criança: fatores de risco aplicados em programas de atenção básica à saúde

“…Conversely, analysis of the low birth weight frequency reveals a decrease among the children registered at the two investigated UBSs. Nevertheless, it is worth noting that in 1995, Project Development was launched (11) , and children exhibiting risk factors for developmental delays, including birth weight < 1,500 g, are referred to this Program straight from maternity. This fact might have interfered with the frequency of low birth weight children registered at the investigated UBSs because the Municipality data for this same period were 9.9% and 9.0% greater in 2005 and 2006, respectively (7) .…”

“…After age 15 months, the mothers are instructed to make routine appointments every six months or whenever they are judged necessary (later, the Program was extended to 18 months). This basic schedule is complemented by several other activities performed at UBSs: medical assistance at non-scheduled visits (9) , assistance programs for children with bronchial asthma and/or recurrent wheezing (10) , outpatient assistance for children with learning disabilities, and Project Development (Projeto Desenvolver) for children at risk of or with established developmental delays (11) . …”

Efeitos da prematuridade sobre o desenvolvimento de lactentes

“…Há consenso entre pesquisadores de que o efeito cumulativo de risco é mais importante na determinação de problemas emocionais da criança do que a presença de um estressor único, independentemente de sua magnitude 6,7,8 . Os efeitos de tais fatores probabilísticos são avaliados comparando, posteriormente, o desenvolvimento da criança com o da população em geral, no caso da utilização de instrumentos padronizados, ou com o desempenho de grupos controle em que os fatores de risco não foram identificados.…”