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Master's Dissertation
DOI
https://doi.org/10.11606/D.6.2005.tde-19102022-181656
Document
Author
Full name
Cíntia Ginaid de Souza
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2005
Supervisor
Committee
Siqueira, Arnaldo Augusto Franco de (President)
Tanaka, Ana Cristina D'Andretta
Ventura, Gabriel Alberto Brasil
Title in Portuguese
Crianças egressas da UTI neonatal: crescimento e desenvolvimento neuro-psico-motor, nos dois primeiros anos de vida
Keywords in Portuguese
Baixo-Peso
Crescimento
Desenvolvimento
Fator de Risco
Follow-up
Prematuridade
Recém-Nascido de Risco e Alto-Risco
Seguimento
Abstract in Portuguese
Objetivo: Descrever o desempenho relativo ao peso e ao desenvolvimento neuro-psico-motor (DNPM) e identificar possíveis fatores determinantes da inadequação do peso com 1 (Pi1) e aos 2 anos (Pi2) e da presença de distúrbio grave do DNPM aos 2 anos de vida, de egressos da UTI Neonatal (UTIN). Metodologia: Foram coletados dados secundários de 203 pacientes acompanhados até os 2 anos de idade no Programa de Follow-up do Hospital Dr. Dório Silva - Serra - ES, num período de 10 anos. As variáveis de desfecho foram relacionadas a algumas variáveis explicativas obstétricas, relativas ao recém-nascido e à sua evolução na UTIN. Para cada uma foi apurada a frequência simples e utilizados modelos lineares generalizados, aplicando-se um método stepwise, com análise de resíduos. Resultados: Observou-se um aumento de quase 20% na proporção de crianças entre os percentis 10 e 90 e uma diminuição de cerca de 40% de crianças abaixo do percentil 5, entre o 1º e 2º ano de vida. Quase 60% dos RN apresentaram desenvolvimento neurológico normal e pouco menos de 15% apresentou distúrbio neurológico grave. As variáveis que permaneceram influenciando a Pi1 e a Pi2 relacionaram-se ao peso de nascimento e à idade gestacional, com exceção da hipoglicemia. O exame neurológico foi a variável mais expressiva para explicar o distúrbio neurológico grave. Conclusões: A hipoglicemia foi um achado novo para explicar a inadequação do peso. Os resultados, de difícil comparação e inéditos em nosso meio, poderão servir para a identificação de fatores de risco e para uma abordagem mais adequada dos recém-nascidos egressos da UTI neonatal.
Title in English
Children discharged from nenatal intensive care unity: neuro-psycho-motor development at the first two years of life
Keywords in English
Birth Weight
Follow-Up Studies
Infant (Newborn)/growth & development
Infant (Premature)
Risk Factors
Abstract in English
Objectives: To describe the performance related to weight and neuro-psychomotor development (NPMD) and to identify possible determinant factors for weight inadequacy at the ages of one year (Pi1) and two years (Pi2), and for the presence of severe NPMD disturbance, at the age of two years, of children discharged from a neonatal intensive care unit (NICU). Methods: Data were obtained from the files of 203 children followed up to 2 years of age in the Follow-up Program of the Dr. Dorio Silva Hospital, at Serra, ES., in a 10-year period. Outcome variables were tested against some explicative obstetric, pediatric, and related to the permanence of the baby in the NICU. Simple frequences were obtained for each variable and linear generalised models were used, in a step-wise multiple regression with residue analysis. Results: An increase of almost 20 percent was observed in the proportion of children with weights between the 1oth and 90th percentiles and a decrease of 40 percent of children below the fifth percentile from the age one year to the age two years. In almost 60 percent of the cases, NPMD was found to be normal at age 2 years, an less than 15 percent of the children showed an abnormal development at that age. Varibales that remained influencing Pi1 and Pi2 were related to birth weighy and gestational age, with exception of hipoglicemy. Neurologic exam was the most influent variable for a severe neurological disturbance. Conclusions: Hypoglycemia was considered to be a new fact to explain weight inadequacy. The results, inedit in Brazil and difficult to compare, could be used to identify risk factors and for a better approach of newborn babies discharged from NICUs.
 
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Publishing Date
2022-10-19
 
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