RESUMO
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.
Assuntos
Deficiências do Desenvolvimento/epidemiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Brasil/epidemiologia , Displasia Broncopulmonar/epidemiologia , Transtornos Cognitivos/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Transtornos do Desenvolvimento da Linguagem/epidemiologia , Leucomalácia Periventricular/epidemiologia , Modelos Lineares , Masculino , Transtornos das Habilidades Motoras/epidemiologia , Prevalência , Desempenho Psicomotor , Fatores de Risco , Distribuição por Sexo , Transtornos do Comportamento Social/epidemiologiaRESUMO
Com objetivo de identificar o perfil sócio-demográfico e comportamental de gestantes adolescentes, foram entrevistadas mil adolescentes, admitidas entre 24 de julho de 2001 e 27 de novembro de 2002, em um hospital municipal de São Paulo, Brasil, correspondendo a 24,3 por cento das internações para resolução da gestação. Setenta (7 por cento) adolescentes foram admitidas para curetagem pós-abortamento e 930 (93 por cento), para parturição, com idade média de 17 ± 1,5 anos. A maioria (72,4 por cento) residia próximo ao hospital e 93 por cento pertenciam às classes econômicas C, D e E. Na época da parturição, 627 (67,3 por cento) adolescentes não estudavam. Apenas 23,7 por cento das adolescentes faziam uso de método contraceptivo, 81,2 por cento não tinham planejado a gestação e 80,1 por cento eram primigestas. Dos partos, 67,4 por cento foram vaginais. Dos bebês, 13,3 por cento foram pré-termo e 15, 9 por cento, baixo peso. Durante a gestação, o consumo referido de tabaco, de álcool e de drogas ilícitas foi, respectivamente de 17,3 por cento, 2,8 por cento e 1,7 por cento. Conclui-se que gravidez na adolescência é um fenômeno complexo, associado a fatores econômicos, educacionais e comportamentais, precipitando problemas decorrentes da maternidade precoce. O presente estudo fornece subsídios para políticas públicas de saúde, visando a prevenir a gravidez na adolescência.
To identify the socio-demographic behavioral profile of low-income pregnant teenagers, 1,000 adolescents admitted to a Brazilian public maternity hospital from July 24, 2001, to November 27, 2002, were interviewed. Socio-demographic and behavioral variables were assessed through a questionnaire. Over the 492 days of the study, 24.3 percent of admissions were adolescents (930 for childbirth and 70 for miscarriage). Mean maternal age was 17 years. Most teenagers (72.9 percent) lived near the hospital. 930 (93 percent) belonged to socioeconomic classes C, D, and E. School dropout was identified in 67.3 percent of the total. 80.1 percent of the subjects were giving birth for the first time. 81.2 percent had not planned the pregnancy, and 23.8 percent had been using some contraceptive method. 67.4 percent had vaginal deliveries. Some 13.3 percent of the newborns were premature and 15.9 percent had low birth weight. 17.3 percent of these adolescent mothers reported smoking during pregnancy, with 2.8 percent reporting alcohol and 1.7 percent illicit drugs. Teenage pregnancy is a complex phenomenon associated with various economic, educational, and behavioral factors. The study provides importance references for public policies to prevent teenage pregnancy.
Assuntos
Adulto , Humanos , Adolescente , Feminino , Criança , Gravidez , Comportamento do Adolescente , Alcoolismo , Distribuição de Qui-Quadrado , Comportamento Contraceptivo , Estudos Transversais , Assistência Perinatal , Áreas de Pobreza , Gravidez na Adolescência , Cuidado Pré-Natal , Comportamento Sexual , Fatores Socioeconômicos , Brasil , Fatores de Risco , Classe Social , TabagismoRESUMO
To identify the socio-demographic behavioral profile of low-income pregnant teenagers, 1,000 adolescents admitted to a Brazilian public maternity hospital from July 24, 2001, to November 27, 2002, were interviewed. Socio-demographic and behavioral variables were assessed through a questionnaire. Over the 492 days of the study, 24.3% of admissions were adolescents (930 for childbirth and 70 for miscarriage). Mean maternal age was 17 years. Most teenagers (72.9%) lived near the hospital. 930 (93%) belonged to socioeconomic classes C, D, and E. School dropout was identified in 67.3% of the total. 80.1% of the subjects were giving birth for the first time. 81.2% had not planned the pregnancy, and 23.8% had been using some contraceptive method. 67.4% had vaginal deliveries. Some 13.3% of the newborns were premature and 15.9% had low birth weight. 17.3% of these adolescent mothers reported smoking during pregnancy, with 2.8% reporting alcohol and 1.7% illicit drugs. Teenage pregnancy is a complex phenomenon associated with various economic, educational, and behavioral factors. The study provides importance references for public policies to prevent teenage pregnancy.