Relação entre baixo peso ao nascimento, fatores ambientais e o desenvolvimento motor e cognitivo na idade pré-escolar

Abstract

Preterm children with low weight are more susceptible to disorders or delays in their development. Environmental factors can aggravate or attenuate the effects of the biological risk factors on the short- and long-term developmental outcome of those infants. The aim of the present study was to examine the relationships between the birth weight, environmental factors, and motor and cognitive development of preschool children. A cross-sectional and descriptive study of a sample of infants born with weight 1,500 grams in the city of Divinópolis, Minas Gerais, Brazil, was conducted considering the years of 2001 and 2002. Measures of motor and cognitive performance, as well as the quality of the home environment were compared between these infants and full terms with adequate weights. The motor performance was evaluated by the Movement Assessment Battery test for Children (MABC) and the parents answered the Developmental Coordination Disorder Questionnaire (DCDQ) Brazil. Cognitive skills were assessed by the vocabulary and cube tests of the Weschsler Intelligence Test for Children llI (WISC), whereas the quality of the home environment was evaluated by the Home Observation for Measurement of the Environment (HOME) scale. In addition, the teachers answered the Swanson, Nolan and Pelham IV Scale (SNAP IV). Before data collection, inter-examiner reliability . was investigated using intra-class correlation coefficients (ICCs). Mann-Whitney U and Chi-Square tests were employed to investigate differences between the groups and Spearman correlation coefficients were calculated to examine the associations between the total results and the most relevant variables. Significant differences between the groups were found in all variables except for the MABCs manual dexterity and balance as well as the hyperactivity domain of the SNAP IV. The group with appropriate weight showed higher scores in the HOME and overall better performance on all measures. High correlations were found between the birth weight, HOME, and the motor and cognitive test scores. The findings reaffirmed the both the importance of follow-up programs for children with low birth weight up to school age and the relevance of the quality of the home environment for childrens development.