Relaçao entre fatores de risco biológico e ambiental e o desenvolvimento motor e funcional de crianças nascidas pré-termo e a termo

Abstract

Preterm newborns weighing less than 1.500 g and with gestational age below 34 weeks are at greater risk for deficits in the development and disabling conditions than those born full term. The objectives of this study were to compare the motor development of preterm infants at 12, 15 and 18 months, corrected age, with full term peers to investigate the relationship between motor development, functional performance and the quantity and quality environmental stimuli. Quantitative study, exploratory, longitudinal and directional, which included 30 preterm infants (gestational age = 30 ± 2.3 weeks and birth weight = 1177.6 ± 193.4 grams) 30 full term infants (gestational age = 39 ± 1.3 weeks and birth weight = 3269.8 ± 399.5 grams). Motor development was assessed using tests of Alberta Infant Motor Scale (AIMS) and Peabody Developmental Motor Scales (PDMS-2). The home environment was assessed with the Home Observation Measurement of the Environment (HOME). To examine the functional abilities of the children the Pediatric Evaluation of Disability Inventory (PEDI) was used There was a delay in the walking age in the preterm group (p = 0.005), although no significant difference between groups on the AIMS at 12 (p = 0.187) and at 15 months (p = 0.80) were found. At 18 months significant differences were found in gross motor development (p = 0.000) and thin (p = 0.001) and in functional abilities, with advantage to the term group. There were significant differences between groups in the quality of home environment, as assessed by the Home Inventory (0.008). There was an increase in the difference between groups on motor performance from 12 to 18 months, and environmental factors appear to enhance the effects of biological risk. Developmental follow up programs should focus on aspects of the environment where the child lives and not be restrict to motor rating.