Vulnerabilidades e exposição ao vírus do HIV em lactentes: intervenção destes critérios para o desenvolvimento neuropsicomotor
Data
2020-11-04
Autores
Masutti, Carolinna Marquez da Costa Brites 
Orientadores
Sá, Cristina dos Santos Cardoso de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
INTRODUÇÃO: A AIDS (Síndrome de Imunodeficiência Adquirida) é a manifestação mais grave e avançada da infecção pelo retrovírus humano chamado HIV, definida como o estágio mais avançado de um processo viral que ataca o sistema imunológico humano, destruindo as células de defesa do organismo. A transmissão vertical é caracterizada pela passagem do vírus do HIV de mãe para o filho durante a gestação, e nesta situação, o feto fica exposto continuamente aos antirretrovirais em sua formação, sendo descrito efeitos colaterais em seu desenvolvimento por conta destas medicações. Por outro lado, existem vulnerabilidades individuais, sociais e programáticas a estes lactentes que interferem no desenvolvimento neuropsicomotor, principalmente dos primeiros 18 meses de vida. OBJETIVO: identificar as características dos cuidados realizados pelas mães durante o período pré-natal e as condições sociais dos lactentes expostos ao vírus HIV, verificar os tipos de vulnerabilidade que os lactentes expostos ao HIV apresentam e suas influências no desenvolvimento neuropsicomotor de lactentes expostos ao HIV, além da relação entre as vulnerabilidades e o desenvolvimento neuropsicomotor com a exposição ao HIV. MÉTODO: estudo de caráter observacional e transversal. Sessenta lactentes de ambos os sexos com as idades de 4, 8, 12 e 18 meses e vida filhos de mães soropositivas em atendimento no SAE Infantil foram avaliados pelo Teste de Triagem do Desenvolvimento de Denver II; para a caracterização das famílias foi realizada anamnese e levantamento de dados do prontuário para informações gestacionais, peri e pós-natal e dados descritivos familiares que possam ser relevantes para a questão da vulnerabilidade. As vulnerabilidades social, individual e programática foram analisadas, e estas foram comparadas com cada variável na Escala de DENVER II descrita nos resultados. RESULTADOS: Dentre as vulnerabilidades encontradas as sociais, como sorodiscordância entre os pais, pais separados, se há situação de rua ou abrigo entre as famílias avaliadas, renda salarial familiar e drogadição. A relação entre as variáveis e DENVER II que foram estatisticamente significantes, destaca-se dentre a relação com motricidade fina, a idade materna, idade de avaliação dos lactentes e a situação de abrigo; relação com motricidade grossa enfatizamos o tipo de parto; relação com linguagem, a idade de avaliação dos lactentes e em relação a DENVER II e pessoal –social, a relevância da drogadição dos pais. CONCLUSÃO: Lactentes expostos ao vírus do HIV apresentam desenvolvimento neuropsicomotor questionável quando comparado às vulnerabilidades sociais de acordo com variáveis descritas em DENVER II. Uma equipe multidisciplinar com profissionais engajados em prol de mulheres que vivem com o vírus do HIV desde sua gestação até todo o acompanhamento deste lactente é primordial dentro de um Serviço e Saúde, incluindo avaliação do primeiro atendimento do recém nascido, com uma anamnese padrão, histórico familiare, pré natal, comorbidades existentes e questionamento das vulnerabilidades são necessários para reforçar e aprimorar em Serviços que atendem este demanda de pacientes
INTRODUCTION: AIDS (Acquired Immunodeficiency Syndrome) is the most serious and advanced manifestation of infection by the human retrovirus called HIV, defined as the most advanced stage of a viral process that attacks the human immune system, destroying the body's defense cells. Vertical transmission is characterized by the passage of the HIV virus from mother to child during pregnancy, and in this situation, the fetus is continuously exposed to antiretrovirals in its formation, with side effects on its development being described because of these medications. On the other hand, there are individual, social and programmatic vulnerabilities to these infants that interfere with neuropsychomotor development, especially in the first 18 months of life. OBJECTIVE: to identify the characteristics of care provided by mothers during the prenatal period and the social conditions of infants exposed to the HIV virus, to verify the types of vulnerability that infants exposed to HIV have and their influences on the neuropsychomotor development of infants exposed to HIV, in addition to the relationship between vulnerabilities and neuropsychomotor development with exposure to HIV. METHOD: observational and cross-sectional study. Sixty infants of both sexes, aged 4, 8, 12 and 18 months and the children of HIV-positive mothers in attendance at SAE Infantil were evaluated by the Denver II Developmental Screening Test; Anamnesis and data collection from medical records for gestational, peri- and post-natal information and family descriptive data that may be relevant to the issue of vulnerability were performed to characterize families. Social, individual and programmatic vulnerabilities were analyzed, and these were compared with each variable on the DENVER II Scale described in the results. RESULTS: Among the vulnerabilities found were social ones, such as serodiscordance between parents, separated parents, whether there is homelessness or homelessness among the families assessed, family salary income and drug addiction. The relationship between variables and DENVER II, which were statistically significant, stands out among the relationship with fine motor skills, maternal age, age of assessment of infants and the situation of shelter; relationship with gross motor skills we emphasize the type of delivery; relationship with language, the age of assessment of infants and in relation to DENVER II and personal - social, the relevance of drug addiction of parents. CONCLUSION: Infants exposed to the HIV virus show changes in neuropsychomotor development when compared to social vulnerabilities according to variables described in DENVER II. A multidisciplinary team with professionals engaged on behalf of women living with the HIV virus from their pregnancy to the entire follow-up of this infant is paramount within a Service and Health, including assessment of the newborn's first care, with a standard anamnesis, family history, prenatal care, existing comorbidities and questioning of vulnerabilities are necessary to reinforce and improve services that meet this patient demand
INTRODUCTION: AIDS (Acquired Immunodeficiency Syndrome) is the most serious and advanced manifestation of infection by the human retrovirus called HIV, defined as the most advanced stage of a viral process that attacks the human immune system, destroying the body's defense cells. Vertical transmission is characterized by the passage of the HIV virus from mother to child during pregnancy, and in this situation, the fetus is continuously exposed to antiretrovirals in its formation, with side effects on its development being described because of these medications. On the other hand, there are individual, social and programmatic vulnerabilities to these infants that interfere with neuropsychomotor development, especially in the first 18 months of life. OBJECTIVE: to identify the characteristics of care provided by mothers during the prenatal period and the social conditions of infants exposed to the HIV virus, to verify the types of vulnerability that infants exposed to HIV have and their influences on the neuropsychomotor development of infants exposed to HIV, in addition to the relationship between vulnerabilities and neuropsychomotor development with exposure to HIV. METHOD: observational and cross-sectional study. Sixty infants of both sexes, aged 4, 8, 12 and 18 months and the children of HIV-positive mothers in attendance at SAE Infantil were evaluated by the Denver II Developmental Screening Test; Anamnesis and data collection from medical records for gestational, peri- and post-natal information and family descriptive data that may be relevant to the issue of vulnerability were performed to characterize families. Social, individual and programmatic vulnerabilities were analyzed, and these were compared with each variable on the DENVER II Scale described in the results. RESULTS: Among the vulnerabilities found were social ones, such as serodiscordance between parents, separated parents, whether there is homelessness or homelessness among the families assessed, family salary income and drug addiction. The relationship between variables and DENVER II, which were statistically significant, stands out among the relationship with fine motor skills, maternal age, age of assessment of infants and the situation of shelter; relationship with gross motor skills we emphasize the type of delivery; relationship with language, the age of assessment of infants and in relation to DENVER II and personal - social, the relevance of drug addiction of parents. CONCLUSION: Infants exposed to the HIV virus show changes in neuropsychomotor development when compared to social vulnerabilities according to variables described in DENVER II. A multidisciplinary team with professionals engaged on behalf of women living with the HIV virus from their pregnancy to the entire follow-up of this infant is paramount within a Service and Health, including assessment of the newborn's first care, with a standard anamnesis, family history, prenatal care, existing comorbidities and questioning of vulnerabilities are necessary to reinforce and improve services that meet this patient demand
Descrição
Citação
MASUTTI, Carolinna Marquez da Costa Brites. Vulnerabilidades e exposição ao vírus do HIV em lactentes: intervenção destes critérios para o desenvolvimento neuropsicomotor. 2020. 65 f.
Dissertação (Mestrado Interdisciplinar em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020.