Fatores associados às desordens do sono em bebês nascidos pré-termo e com baixo-peso

Abstract

Sleep problems are associated with several shortcomings especially in the first years of life. Infants born preterm are more prone to have health injuries and also sleep disorders. This cross-sectional study evaluated the associated factors with sleep disorders (SD) in preterm and low birth weight infants and verify the association with type of feeding, sucking habits, and sociodemographic information (Article 1); and maternal health, pregnancy, delivery, sleep ecology, gastroesophageal reflux and sociodemographic information (Article 2). This study was approved by the Institutional Ethics Committee (protocol # 49714121.8.0000.5149). The sample was comprised by 104 dyads of mothers and infants aged 0 to 3 years followed-up in a reference center for preterm children in Belo Horizonte, Ambulatório da Criança de Risco (ACRIAR) from Hospital das Clínicas da Universidade Federal de Minas Gerais. Mothers answered an online questionnaire available on the Google Forms® platform that evaluated maternal health condition, childbirth characteristics, breastfeeding, bottle feeding, non-nutritive sucking habits and also sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ), was used to evaluate the presence of sleep disturbance among infants. Statistical analyses included descriptive analysis, Chi-square test and Logistic Regression Models (p<0.05). Sleep disorders prevalence in this sample was 45.2%. Results from article 1 showed that infants breastfed 3 times or more at night had 5.006 more chances to have SD (CI 95% = 1.229 – 20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 times or more at night had 6.952 more chances to have SD (CI= 95% = 1.364 – 35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% =0.889 – 0.982) for each increase of a month in infant’s age, and those infants from families with higher income had 3.535 more chances to have SD (CI 95% = (1.006 – 12.416). The results from article 2 showed that male infants had 4.041 more chances of having SD than female infants (CI 95% = 1.075 – 15.193). For each increase of a month in infant’s age, the chance of having SD decreases 11.7% (CI 95% = 0.821 – 0.949). Spending 30 minutes or more to sleep in the evening increased 4.014 times the chance of SD compared to spending less than 30 minutes (CI 95% = 1.178 - 13.673). Infants whose mothers consider their child ‘sleep a problem had 18.387 more chances of having sleep disorder (CI 95% = 2.399- 140.926). It was concluded that the youngest is the child (Articles 1 and 2), higher night frequency of breastfeeding or bottle-feeding and belonging to a higher income family (Article 1); and infants who spend 30 minutes or more to sleep in the evening, infants whose mothers consider their child ‘sleep a problem and male infants have more chances to present sleep disorders (Article 2).