Navegando por Palavras-chave "Infant premature"

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    Avaliação do neurodesenvolvimento de prematuros de muito baixo peso ao nascer entre 18 e 24 meses de idade corrigida pelas escalas Bayley III
    (Sociedade Brasileira de Pediatria, 2012-12-01) Fernandes, Luciana Volpiano [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Barros, Marina Carvalho de Moraes [UNIFESP]; Guerra, Camila Campos; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the prevalence of delay and factors associated with neurodevelopmental scores in premature infants. METHODS: Cross-sectional study to assess the development by Bayley Scales III, including very low birth weight preterm infants aged 18 to 24 months who were under follow-up at the outpatient clinic for preterm infants. Congenital malformation, genetic syndrome, symptomatic congenital infection at birth, deafness, and blindness were excluded. Numerical variables were compared by Mann-Whitney or Student t test and categorical variables by chi-square or Fisher's exact test. Factors associated with developmental scores were analyzed by linear regression, and statistical significance level was established at p < 0.05. RESULTS: Out of the 58 children included, four (6.9%) presented cognitive delay, four (6.9%) motor, 17 (29.3%) language, 16 (27.6%) social-emotional and 22 (37.0%) adaptive-behavior delay. By multiple linear regression, the variables: social classes CDE (-13.27; 95%CI: -21.23 to -5.31), oxygen dependency at 36 weeks of corrected age (-8.75; 95%CI: -17.10 to -0.39) decreased the cognitive developmental score. Periventricular leukomalacia decreased the cognitive (-15.21; 95%CI: -27.61 to -2.81), motor (-10.67; 95%CI:-19.74 to -1.59) and adaptive-behavior scores (-21.52; 95%CI: -35.60 to -7.44). The female sex was associated with higher motor (10.67; 95%CI: 2.77 to 12.97), language (15.74; 95%CI: 7.39 to 24.09) and social-emotional developmental scores (10.27; 95%CI: 1.08 to 19.46). CONCLUSIONS: Very low birth weight preterm infants aged from 18 to 24 months of corrected age presented more frequently language, social-emotional and adaptive-behavior delays. The variables: social classes CDE, periventricular leukomalacia, bronchopulmonary dysplasia and male sex reduced the neurodevelopmental scores.
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    Percepção de dor e habilidades funcionais em crianças de 4-6 anos de idade nascidas prematuras com experiência prévia de dor
    (Universidade Federal de São Paulo (UNIFESP), 2018-04-13) Rodrigues, Adriana Cardoso [UNIFESP]; Guinsburg, Ruth [UNIFESP]; http://lattes.cnpq.br/6286661930160341; http://lattes.cnpq.br/1365528322357486; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A exposição à dor repetitiva no período neonatal se associa a alterações da microestrutura cerebral e ao neurodesenvolvimento cognitivo, motor e comportamental mais pobre em prematuros. Objetivo: Analisar, em crianças com 4-6 anos de idade nascidas pré-termo, comparadas a nascidas a termo, se há associação entre o número de procedimentos dolorosos sofridos no período neonatal e a sensibilidade ao estímulo mecânico, a percepção subjetiva de dor e o desempenho funcional. Métodos: Coorte prospectiva de 28 prematuros nascidos de 28-32 semanas de idade gestacional sem malformações congênitas e sem hemorragia intracraniana grave, comparada a 28 crianças de termo saudáveis, todos entre 4-6 anos de idade. Os grupos foram comparados para os desfechos: teste de sensibilidade com o estesiômetro, percepção subjetiva de dor por meio de ilustrações relativas a dor física, dor relacionada a procedimentos médicos e dor decorrente de isolamento social, além de desempenho funcional com o Inventário de Avaliação Pediátrica de Incapacidade (PEDI). Utilizou-se a correlação linear entre os escores obtidos para cada desfecho e o número de procedimentos dolorosos no período neonatal e foi aplicada a análise de variância (ANOVA) para tais desfechos com dois fatores: classe socioeconômica (A/B ou C/D) e número de procedimentos dolorosos até 28 dias. Resultados: Não houve diferenças quanto à percepção de dor desencadeada por estímulo mecânico e à avaliação subjetiva da dor pela própria criança em situações hipotéticas de dor física, procedimentos médicos e situações psicossociais. Não foram encontradas correlações entre o número de procedimentos dolorosos no período neonatal e a avaliação de dor sentida pelas crianças entre 4-6 anos de idades em situações hipotéticas de dor física, dor decorrente de procedimentos médicos e dor psicossocial. Na análise multivariada, mais de 25 procedimentos dolorosos no período neonatal, em associação com o nível socioeconômico ampliou a percepção de dor desencadeada por situação de isolamento social. No que se refere ao desempenho funcional, o grupo pré-termo apresentou maior dificuldade para a execução dos itens relativos à mobilidade do que os nascidos a termo. Não foram encontradas correlações entre o número de procedimentos dolorosos e o escore do PEDI em todos os seus domínios. Na ANOVA, para os domínios autocuidados e mobilidade, houve pior desempenho das crianças de nível socioeconômico elevado (A/B) submetidas a mais de 25 procedimentos dolorosos no período neonatal, comparadas às que não receberam procedimentos dolorosos no período neonatal. Conclusão: A exposição a procedimentos dolorosos repetitivos no período neonatal parece atuar em conjunto com fatores ambientais como um dos múltiplos moduladores do neurodesenvolvimento.
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    Repercussões da prematuridade na estrutura musculoesquelética torácica na adolescência
    (Universidade Federal de São Paulo (UNIFESP), 2011-04-27) Garcia, Kessey Maria Bini [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To analyze thoracic musculoskeletal characteristics in adolescents aged 10- 15 years born prematurely and in adolescents of the same age born at term. Methods: Cross-sectional study performed from Dec/2007 to Dec/2009 with adolescents from 10-15 years of age. Premature group: adolescents born before 37 week of gestational age and birth weight <2000g, followed up regularly at the Premature Clinic at the Federal University of São Paulo; Control group: adolescents born at term and healthy. Exclusion criteria were: major congenital malformations, neuromuscular and chromosomal diseases and severe neurological disabilities. Adolescents born prematurely were paired by gender and chronological age with those born at term. The adolescents were photographed in bathing suits, focusing the cephalic and thoracic segments. The images were analyzed by a computer program named SAPO for the following angle measurements: right acromion/manubrium/left acromion (elevation of the clavicles); manubrium/right acromion/right trapezium (elevation of the right shoulder); manubrium/left acromion/left trapezium (elevation of the left shoulder); seventh cervical vertebra/third thoracic vertebra/perpendicular line to the ground (protrusion of the head). It was also measured the laterolateral and anteroposterior thoracic distance and the rate between both. The study was approved by the Ethics Committee of the Federal University of São Paulo/São Paulo Hospital and parents/guardians signed terms of informed consent. Results: Fifty seven adolescents born prematurely were included (gestational age: 32.0±2.8 weeks; birth weight: 1462±338g; 41.9% male), paired with 57 adolescents born at term (birth weight: 3342±430g; 41.9% male). At the inclusion, except by asthma prevalence in the childhood, which was lower in the premature infants, adolescents of both groups were similar in regard to demographic and clinical characteristics that could influence the thoracic cage conformation. The elevation of the clavicles had a tendency to be smaller in the premature group (172.8±7.0o vs. 175,2±7,9o; p=0,083). The elevation of the left shoulder (22.7±5.4o vs. 20,4±5,4o; p=0,028) and the elevation of the right shoulder (22.2±4.4o vs. 18,5±5,8o; p<0.001) were larger, compared to the control group. The protrusion of the head was smaller among those born prematurely (27.8±6.3o vs. 32,5±7,7o; p=0.001). The laterolateral thoracic measure (22.9±2.3cm vs. 25.2±3.4cm; p<0.001) and anteroposterior (19.7±2.2cm vs. 21.3±3.4cm; p=0.002) were smaller in the premature group, but the ratio between them (1.17±0.08 vs. 1.19±0.10; p=0.179) was similar in both groups. Adolescents born very low birth weight (n=33), compared with those who was born with birth weight >1500g (n=30), presented larger elevation of the right shoulder angle (24.1±4.2o vs. 20.3±3.8o, p<0.001) and left shoulder angle (25.3±5.4o vs. 20.2±4.0o; p<0.001). By linear multiple regression analysis, adjusted for gestational age <37 weeks, birth weight <1500g, mechanical ventilation >5 days and oxygen therapy >15 days, the shoulder elevation angle increased 4.41o (95% CI: 2.23-6.60; p<0.001) in adolescents with birth weight <1500g and 5.56o (95% CI: 1.40-9.72; p=0.009) in the adolescent submitted to more than five days to mechanical ventilation in the neonatal period. Conclusions: Adolescents who were born prematurely presented greater elevation of the shoulder, smaller protrusion of the head, and smaller dimension of the thoracic cage in its laterolateral and anteroposterior dimensions, compared to those born at term. The shoulders were even more elevated in very low birth weight preterm adolescents, compared to those born with or more than 1500g.
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    Sucção do recém-nascido prematuro: comparação do método Mãe-Canguru com os cuidados tradicionais
    (Instituto de Medicina Integral Prof. Fernando Figueira, 2005-03-01) Andrade, Izabella Santos Nogueira De; Guedes, Zelita Caldeira Ferreira [UNIFESP]; Universidade de Fortaleza; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: to compare premature newborns' suction in the Mother-Kangoroo method with newborns submitted to traditional care. METHODS: thirty premature newborns with gestational age between 30 and 35 weeks were selected. The samples were comprised of two groups: Group 1: 16 newborns of the Mother Kangoroo Ward of the Maternity School Assis Chateaubriand and Group 2: formed by 14 newborns submitted to traditional care, i.e. Medium Risk Nursery of the General Hospital of Fortaleza. All newborns were evaluated and submitted to phoniatric intervention in the process of hospital discharge. RESULTS: in Group 1 there was a significant improvement related to behavior, stress signs, coordination and suction rhythm. Hospital stay was considerably shorter. In group 2 there was a significant improvement related to the coordination between suction, deglutition and breathing. CONCLUSIONS: newborns of both groups were benefited by phoniatrics, nevertheless, the best results related to the Kangaroo-Mother Method. It has been noted that this method is a good alternative for developing countries for it contributes to the effectiveness of nursing, shortening hospital stay and reducing public health costs.