Avaliação do neurodesenvolvimento em prematuros submetidos ao método canguru - um estudo de coorte

Abstract

Introduction: The implementation of the Kangaroo Method (KM) has been recommended in several countries, as a strategy to minimize the risks of neuromotor disorders in premature newborns (PTNB). However, little is known about the influence of MC on the development of these babies. Objective: Follow the motor development trajectory of PTNBs submitted to KMC and identify their motor evolution in the first 4 months of life. Methodology: This is a cohort study conducted at the Maternidade Escola Januário Cicco. Twenty-two PTNB, with gestational age less than 37 weeks and weight below 2500g, participated in the follow-up. The babies were submitted to 4 evaluations (Av1 to Av4). The first 3 were performed in the 3 phases of the MC and the fourth in the outpatient clinic. The generalized movements (GM) of the babies were evaluated in the three stages of the KM and in the segment; motor development was assessed in the second and third stages of the KM and in the follow-up, through the Test Infant Motor Performance (TIMP). For statistical analysis, a significance level of 5% and a 95% confidence interval were assigned to all analyzes. Descriptive analysis was presented as mean and standard deviation (SD). The normality of the study variables was verified using the Shapiro Wilk test. To compare means between groups, the Mann-Whitney was used and for categorical variables, the Chi-square test was used. Results: The GM analysis showed a gradual improvement in the motor repertoire. The sample was composed of 22 babies, with gestational age at birth of 32 (32) weeks and average hospitalization time of 34.65 (29) days. Generalized movements showed a decrease in repertoire over the course of evaluations, from 86.3% in Ev1 to 13.6% in Ev4. In the TIMP, motor performance declined from 63.6% in Ev2 to 13.6% in Ev4.The analysis of clinical factors showed that they are associated with atypical development. number of prenatal consultations (p = 0.02), sex (p = 0.04), 1st minute apgar (p = 0.00), O2 days (p = 0.00), phototherapy days ( p = 0.00), gestational age and weight of admission to the ward (p = 0.00) and (p = 0.04), respectively. Conclusion: Babies submitted to KM showed a gradual improvement in generalized movements and motor repertoire with increasing age. The importance of early investigation of neurodevelopment in the hospital environment is emphasized and this can be associated with the kangaroo method which becomes a key element in family empowerment and engagement, making the hospital and home environment enriched with the potential to promote and change the standard of care motor development.