Percepção da mãe sobre o desenvolvimento motor de lactentes expostos ao HIV
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Data
2021-02-26
Autores
Souza, Gabriela de Assis [UNIFESP]
Orientadores
Sá, Cristina dos Santos Cardoso de [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
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Introdução: As mulheres soropositivas podem transmitir o vírus para o filho por transmissão vertical (TV), a qual pode ocorre durante a gestação, durante o nascimento e ao amamentarem o filho lactente. O uso da terapia antirretroviral (TARV) diminui a carga viral e assim, a possibilidade de transmissão, além disso, elas são orientadas a realizarem a cesárea e a não amamentar. A mulher pode optar pela via de parto vaginal se a carga viral dela for menor a 1000 cópias/mL após a 34ª semana de gestação. Contudo, o contato do lactente com a TARV pode acarretar atraso no desenvolvimento neuromotor. Somado à TARV, a exposição ao HIV também pode acarretar em atrasos motores. Por isso é necessário o acompanhamento destes lactentes e entender o conhecimento da família acerca dos estímulos mais adequados a cada idade. Este estudo avaliou o desenvolvimento motor de lactentes expostos e não expostos ao HIV, e verificou se a percepção das mães se aproxima das habilidades motoras destes lactentes. Métodos: Foram avaliados 34 lactentes filhos de mães soropositivas acompanhadas no SAE infantil – Santos e 34 lactentes não expostos ao HIV acompanhados pela equipe de saúde da Unidade Básica de Saúde Vila Nova nas idades de 4, 8, 12 e 18 meses por meio da Alberta Infant Motor Scale (AIMS) e, pelo Guia Portage adaptado respondido pelas mães sobre a percepção do desenvolvimento motor de seus filhos. Resultados: Não foram encontradas diferenças significativas na percepção das mães entre os grupos de lactentes expostos e não expostos. Vale ressaltar que ao correlacionar a percepção da mãe sobre o desenvolvimento do lactente e o desenvolvimento real do lactente, houve correlação forte, apenas aos 4 meses. Com relação ao desenvolvimento motor dos lactentes não houve diferença significativa entre os lactentes expostos ao HIV e não expostos, exceto no grupo de 12 meses dos lactentes exposto os quais obtiveram resultados menores quando comparados com os não expostos da mesma idade. Conclusão: Um desenvolvimento motor adequado é importante para todos os lactentes, o conhecimento sobre os marcos motores de cada fase auxilia no rápido reconhecimento de possíveis atrasos. Este estudo não encontrou diferenças significativas entre lactentes expostos e não expostos, contudo houve uma diferença no escore bruto e percentil de desenvolvimento dos lactentes expostos ao HIV com 12 meses, obtendo menor escores comparado ao grupo não exposto. A percepção da mãe só aproximou-se da realidade com os lactentes de 4 meses de idade, indicando a necessidade de orientá-las sobre as fases motoras que seu filho lactente está passando.
Introduction: HIV-positive women can transmit the virus to their child through vertical transmission (VT) which can occur during pregnancy, during birth and when breastfeeding the infant. The use of antiretroviral therapy (TARV) decreases viral load and thus the possibility of transmission, in addition to performing cesarean sections and being instructed not to breastfeed. The woman can choose the vaginal delivery route if her viral load is less than 1000 copies / mL after the 34th week of pregnancy. However, the infant's contact with TARV can cause a delay in neuromotor development. As well to TARV, exposure to HIV is also linked to motor delays. Therefore, it is necessary to monitor these infants and understand the family's knowledge about the most appropriate stimuli for each age. This study evaluated the motor development of infants exposed and not exposed to HIV, and verified whether the mother’s perception is close to the motor skills of these infants. Methods: 34 infants born to HIV-positive mothers were monitored at the children's SAE - Santos and 34 infants not exposed to HIV who were followed up by the health team of Basic Health Unit, at the ages of 4, 8, 12 and 18 months were evaluated using the Alberta Infant Motor Scale (AIMS) and, in sequence, by the adapted Portage Guide answered by mothers about the perception of their children's motor development. Results: No significant differences were found in the perception of mothers between the groups of exposed to HIV and unexposed infants. It is worth mentioning that when correlating the mother's perception of the infant's development and the infant's actual development, there was a strong correlation, only at 4 months. Regarding the motor development of infants, there was no significant difference between exposed and unexposed infants, except in the 12-month group of exposed infants who obtained lower results when compared to the unexposed infants of the same age. Conclusion: Adequate motor development is important for all infants, knowledge of the motor milestones of each phase helps to quickly recognize possible delays. This study found no significant differences between exposed and unexposed infants, however there was a difference in the raw score and developmental percentile of infants exposed to HIV at 12 months, obtaining lower scores compared to the unexposed group. The mother's perception only approached reality with 4-month-old infants, indicating the need to guide them about the motor phases that their infant child is going through.
Introduction: HIV-positive women can transmit the virus to their child through vertical transmission (VT) which can occur during pregnancy, during birth and when breastfeeding the infant. The use of antiretroviral therapy (TARV) decreases viral load and thus the possibility of transmission, in addition to performing cesarean sections and being instructed not to breastfeed. The woman can choose the vaginal delivery route if her viral load is less than 1000 copies / mL after the 34th week of pregnancy. However, the infant's contact with TARV can cause a delay in neuromotor development. As well to TARV, exposure to HIV is also linked to motor delays. Therefore, it is necessary to monitor these infants and understand the family's knowledge about the most appropriate stimuli for each age. This study evaluated the motor development of infants exposed and not exposed to HIV, and verified whether the mother’s perception is close to the motor skills of these infants. Methods: 34 infants born to HIV-positive mothers were monitored at the children's SAE - Santos and 34 infants not exposed to HIV who were followed up by the health team of Basic Health Unit, at the ages of 4, 8, 12 and 18 months were evaluated using the Alberta Infant Motor Scale (AIMS) and, in sequence, by the adapted Portage Guide answered by mothers about the perception of their children's motor development. Results: No significant differences were found in the perception of mothers between the groups of exposed to HIV and unexposed infants. It is worth mentioning that when correlating the mother's perception of the infant's development and the infant's actual development, there was a strong correlation, only at 4 months. Regarding the motor development of infants, there was no significant difference between exposed and unexposed infants, except in the 12-month group of exposed infants who obtained lower results when compared to the unexposed infants of the same age. Conclusion: Adequate motor development is important for all infants, knowledge of the motor milestones of each phase helps to quickly recognize possible delays. This study found no significant differences between exposed and unexposed infants, however there was a difference in the raw score and developmental percentile of infants exposed to HIV at 12 months, obtaining lower scores compared to the unexposed group. The mother's perception only approached reality with 4-month-old infants, indicating the need to guide them about the motor phases that their infant child is going through.
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Citação
SOUZA, Gabriela de Assis. Percepção da mãe sobre o desenvolvimento motor de lactentes expostos ao HIV. 2021. 44f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2021.