Alterações sensoriais e fatores associados em prematuros de muito baixo peso nos primeiros 2 anos de vida
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Data
2020-02-28
Autores
Prodócimo, Rafaela Fioretto Manchini
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A prematuridade é fator de risco para distúrbios sensoriais, pois interrompe o desenvolvimento sensorial normal expondo o recém-nascido à estimulação nociva durante a internação. Objetivo: Investigar a frequencia, tipo e grau de alterações no processamento sensorial, bem como os fatores de risco associados, em prematuros de muito baixo peso nos primeiros 2 anos. Método: Estudo transversal, com lactentes de 6-24 meses de idade corrigida, nascidos no serviço, com idade gestacional < 34 semanas e peso < 1500g, sem malformações/infecções congênitas e acompanhados no Ambulatório de Seguimento da Instituição, no período de 2018-2019. Após a consulta médica foi aplicado aos pais/cuidadores o questionário Infant Toddler Sensory Profile, que avalia o processamento sensorial e as estratégias de resposta da criança. Conforme os escores obtidos são classificados 3 padrões sensoriais: típico, suspeito, atípico. Variáveis independentes: dados maternos, gestacionais e neonatais. Desfechos: alterações no processamento sensorial. Analise estatística: Teste t de Student ou Mann-Whitney; Qui-quadrado ou teste Exato de Fisher para testar associações entre grupos; correlação de Pearson; e regressão logística múltipla para investigar fatores de risco. Resultados: 50 prematuros de muito baixo peso foram avaliados com 12±6 meses de idade corrigida. Os escores médios do processamento auditivo, tátil, vestibular e oral foram normais, mas nas respostas comportamentais os escores foram baixos. O percentual de padrões sensoriais atípicos foi elevado, especialmente para audição, visão e tato, e foram frequentes padrões de respostas atípicas, especialmente baixo registro, sensibilidade e aversão sensorial. Não foram identificados fatores de risco para as alterações. A idade gestacional não se correlacionou com os escores sensoriais, mas o tempo de internação teve correlação negativa com o escore oral. Conclusão: Alterações no processamento sensorial e no padrão de resposta comportamental são frequentes em prematuros de muito baixo peso, independente da idade gestacional e de outros fatores biológicos de risco.
Background: Prematurity is a risk factor for sensory disorders, as it interrupts normal sensory development, exposing the newborn to harmful stimulation during hospitalization. Objective: To investigate the frequency, type and degree of changes in sensory processing, as well as the associated risk factors, in very low birth weight preterm infants in the first 2 years. Method: Cross-sectional study, with inborn preterm infants < 34 weeks´gestation and birth weight < 1500g, without congenital malformation/infection, and evaluated at 6-24 months corrected age during one of their NICU follow-up clinic visit, between 2018- 2019. After the medical consultation, the Infant Toddler Sensory Profile questionnaire was applied to parents/caregivers, which measures the child's sensory processing and response strategies. According to the scores obtained, 3 sensory patterns are classified: typical, suspicious, atypical. Independent variables: maternal, gestational and neonatal data. Outcomes: abnomalities in sensory processing. Statistical analysis: Student's t-test or Mann-Whitney; Chi-square or Fisher's exact test were used to evaluate associations between groups; Pearson's correlation for the strenght of associations; and multiple logistic regression to investigate risk factors. Results: 50 very low birth weight preterm infants were evaluated at 12 ± 6 months corrected age. The mean scores of auditory, tactile, vestibular and oral processing were normal, but in behavioral responses the scores were low. The percentage of atypical sensory patterns was high, especially for auditory, visual and tactile. Atypical response patterns were frequent, especially low registration, sensory sensitivity, and sensation avoiding. No risk factors were associated with the sensory pattern. Gestational age did not correlate with sensory scores, but the length of hospital stay had a negative correlation with oral score. Conclusion: Abnormal sensory processing and reactivity are frequent in very low birthweight preterm infants, regardless of gestational age and other biological risk factors.
Background: Prematurity is a risk factor for sensory disorders, as it interrupts normal sensory development, exposing the newborn to harmful stimulation during hospitalization. Objective: To investigate the frequency, type and degree of changes in sensory processing, as well as the associated risk factors, in very low birth weight preterm infants in the first 2 years. Method: Cross-sectional study, with inborn preterm infants < 34 weeks´gestation and birth weight < 1500g, without congenital malformation/infection, and evaluated at 6-24 months corrected age during one of their NICU follow-up clinic visit, between 2018- 2019. After the medical consultation, the Infant Toddler Sensory Profile questionnaire was applied to parents/caregivers, which measures the child's sensory processing and response strategies. According to the scores obtained, 3 sensory patterns are classified: typical, suspicious, atypical. Independent variables: maternal, gestational and neonatal data. Outcomes: abnomalities in sensory processing. Statistical analysis: Student's t-test or Mann-Whitney; Chi-square or Fisher's exact test were used to evaluate associations between groups; Pearson's correlation for the strenght of associations; and multiple logistic regression to investigate risk factors. Results: 50 very low birth weight preterm infants were evaluated at 12 ± 6 months corrected age. The mean scores of auditory, tactile, vestibular and oral processing were normal, but in behavioral responses the scores were low. The percentage of atypical sensory patterns was high, especially for auditory, visual and tactile. Atypical response patterns were frequent, especially low registration, sensory sensitivity, and sensation avoiding. No risk factors were associated with the sensory pattern. Gestational age did not correlate with sensory scores, but the length of hospital stay had a negative correlation with oral score. Conclusion: Abnormal sensory processing and reactivity are frequent in very low birthweight preterm infants, regardless of gestational age and other biological risk factors.
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Palavras-chave
Recém nascido prematuro, Transtornos das sensações, Limiar sensorial, Fatores de risco, Premature newborn, Sensation disorders, Sensory threshold, Risk factors