Repercussão da posição canguru na relação mãe-criança pré-termo à alta e aos seis meses de idade gestacional corrigida

Abstract

Separation of the premature mother-child who remains hospitalized for weeks may interfere in the context of this relationship. On the other hand, the Kangaroo Method is the model of perinatal care based on humanized care that involves the strategies of biopsychosocial intervention centered in the family. This has strated, in the mind-standing of newborn weight on the vertical position on the chest of parents. Until now, there are no studies that associate the onset, frequency and duration of position and motherinfant relation. The studies are important to guide the routines, based on scientific evidence, during an internment in the neonatal unit. The objective is to investigate the association between the onset, duration, frequency of the kangaroo position and the interaction between mothers and infants born in discharge from hospital and after six months of corrected age. The study of a longitudinal, panel-type observational study with data collection for discharge from hospital and six months corrected gestational age, with 72 mother-infant dyad, with gestational age 32 weeks, born in two public maternity hospitals in Belo Horizonte between July 2016 and August 2017 and followed up in the outpatient clinic until April 2018. A series of videos on the topic mother-infant with the criteria adopted by the Mother-Baby Observation Protocol, hospital discharge and at 6 months corrected age gestational. The State-Trait Anxiety Inventory Scale was performed when the newborns had two days of life, at hospital discharge and at outpatient follow-up, at six months corrected gestational age, in order to measure signs of maternal anxiety. The Edinburgh Postpartum Depression Scale was applied to the mother between the 7th and 10th day of life of the newborn. The children's language was evaluated as an outpatient with the Protocol Adapted for Evaluation of Children's Language from 2 to 12 months. Measures of central tendency, univariate analysis with Wilcoxon, Spearmann or Pearson and Mann Whitney tests or T test and Linear Regression Tests were done through the Statistical Package for the Social Sciences, version 20.0. Regarding the comparison of the two variables of the interaction, a variable was applied that changed POIMB 0-6 to hospital discharge. This new variable was denominated as development variable. They were listed in the multivariate analysis as variables with p0.20 and as variables with relevance to the study. In the final model the linear regression remains as variables with p-value 0.05. In the analysis of multivariate linear regression, to start a position in three days of life and to be primiparous favorable to the the development of children's interactive behavior of the first semester. Exposure of some mothers to cigarette smoke and each day more than late start of the kangaroo position interfere with the development of mother-child tuning. Maternal age, absence of peri-intraventricular hemorrhage and maintenance of breastfeeding up to six months of corrected gestational age got positive association with the development of the interactive gaze. Start the kangaroo position before the 3rd day, be primiparous, shorter time in the Neonatal Intensive Care Unit favor the development of contact attempts. No peri-intraventricular hemorrhage, fewer days of hospitalization in the Conventional Intermediate Care Unit, be primiparous, starting the position until the 3rd day of life more often during hospitalization favoring a child's responsiveness. Start the kangaroo until the 3rd day of life, infant smile, shorter hospital stay contribution for more children's vocalizations during the interaction. It can be concluded that investing in humanized, family-centered care to ensure maternal presence should be the priority of the care team's conduct and hospital management. Whenever possible, newborns need to start the kangaroo position early.