Navegando por Palavras-chave "Preterm infant"
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- ItemAcesso aberto (Open Access)Avaliação da capacidade física de crianças nascidas prematuras com muito baixo peso(Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Tsopanoglou, Sabrina Pinheiro [UNIFESP]; Santos, Amelia Miyashiro Nunes dos [UNIFESP]; http://lattes.cnpq.br/9925075057283150; http://lattes.cnpq.br/3509876657463607; Universidade Federal de São Paulo (UNIFESP)Objectives: To compare aerobic capacity of children born prematurely with children born at term and to identify factors associated with aerobic capacity of these children during cardiopulmonary exercise test (CPET). Methods: Cross-sectional study with two groups of children aged 6-9 years: one group of children born prematurely with birth weight <1500g and followed at the Preterm out clinic of the Federal University of São Paulo. Children born at term composed the second group; brothers, friends or relatives of preterm children who did not presented clinical complications during neonatal period. Exclusion criteria were: congenital malformations, neuromuscular disorders, neurological, medical or developmental impairment that could compromise the results or safety of the child during the test and/or respiratory disease 15 days prior to testing. For CPET, it was adopted a quickly incremental symptom limited protocol with individualized load increase on treadmill. Variables measured were: oxygen pulse (PuO2), peak of heart rate (HR peak), percentage of maximum heart rate expected for age (% HR max), tidal volume/inspiratory capacity (VC/CI rest and peak), ventilatory equivalent for CO2 (VE/VCO 2 slope and lowest), oxygen consumption (VO2) peak and percentage of maximum predicted oxygen consumption for age (% VO2 max prev.), oxygen consumption at anaerobic threshold/anaerobic threshold (VO2 in LA), maximal oxygen and threshold of maximum percentage provided for oxygen-consuming for age ratio (VO2 @ LA/%VCO2 max. pred), Oxygen Uptake Efficiency Slope (OUES). The sample size calculation required 22 participants in each group, to evidence a difference of 7.3mL/kg/min. in VO2 between groups, considering alpha of 0.05 and beta of 0.80. Categorical variables were compared by chi-square or Fisher's exact test and numeric variables by the student t test or Mann-Whitney, according to their distribution evaluated by the Kolmogorov-Smirnov. Univariate and multiple linear regression analysis were applied to evaluate factors associated with aerobic capacity. Variables with clinical and statistical significance (p <0.2) detected by univariate regression were included in the multivariate model. Statistical analysis was performed using SPSS for Win / v.17.0, considering significant p <0.05. Results: Thirty-four preterm infants were included (gestational age 29.8 ± 2.5 weeks,birth weight 1131 ± 228g) and 32 term children. Among preterm children, 70.6% required mechanical ventilation and the length of stay in the unit neonatal was 61 ± 21 days. At inclusion in the study, both groups were similar in age, weight, height, body mass index and incidence of overweight/obesity, except for the z score for height/age (Preterm group: -0.35 ± 1.17 vs. Term group: 0.24 ± 0.96, p = 0.032). All parameters of aerobic capacity were similar in both groups. By multivariate linear regression: HR peak was positively associated with bronchopulmonary dysplasia and overweight/obesity; %Maximum heart rate was positively associated with broncopulmonary dysplasia, overweight/obesity; PuO2 was positively associated to the z-score for height/age and negatively to female; VO2 peak was positively associated with birth weight <1000 g, and negatively for female and overweight/obese. Conclusions: The parameters of aerobic capacity evaluated by the cardiopulmonary test were similar in both groups. Factors associated with aerobic capacity were female, broncopulmonary dysplasia and variables related to body growth, showing the influence of neonatal factors and postnatal growth on the aerobic capacity of children born prematurely.
- ItemAcesso aberto (Open Access)BINS validation - Bayley neurodevelopmental screener in Brazilian preterm children under risk conditions(Elsevier B.V., 2011-02-01) Guedes, Deborah Zacarias [UNIFESP]; Primi, Ricardo; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Sao FranciscoPsychometric researches increase in Brazil. Bayley Infant Neurodevelopment Screener - BINS (Aylward, 1995) is a low cost, fast instrument. in 10' it classifies children under developmental risk degrees. This research purpose was investigating BINS psychometric properties. 61 low-income Brazilian preterm, were divided in groups: 31 children (12 months) and 30 children (24 months), both sex, birth weight < 2000g. Socio-demographic-psychological profile was previously registered. Neurologists examined them through Amiel-Tison and Gosselin (2001) and physicians with Denver-DDST-II(Frankenburg, Dodds, Archer, & Bresnick, 1990). Psychologist assessed children at chronological age, with Bayley Scales-BSID-II (Bayley, 1993) and BINS (12m) and BINS (24 m). Results demonstrated homogeneous characteristics sample. Reliability indexes were over requested standards. Validity evidences based on external variables were positive moderated and BINS (24 m)/BSID-II (mental) presented high correlation. Validity evidences based on content were attested by expertise. High sensitivity was found. So. BINS can be considered an instrument of adequate psychometric properties, able to screen children under risk, according to Psychological Association requests. (C) 2010 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Impacto dos fatores perinatais nos déficits de crescimento de prematuros(Associação Médica Brasileira, 2011-06-01) Goulart, Ana Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To review perinatal factors associated with a growth deficit in preterm infants at a corrected age of one year. METHODS: Cohort study of preterm infants with a birth weight < 2,000 g. Percentiles and Z scores of body weight (W/A), length (L/A) and head circumference (HC/A) at one year of corrected age were calculated by using the Centers for Disease Control and Prevention curves. RESULTS: Among 303 preterm infants, the frequencies of measures below the 10th percentile (P10) and Z scores -2 were 43.2% and 24.4% for W/A, 22.1% and 8.6% for L/A and 15.8% and 4.6% for HC/A, respectively. Logistic regression analyses showed factors associated with higher odds for W/A < P10 were resuscitation at birth (1.8 times) and small for gestational age infants (3.0 times). In infants rated as small at full-term postconceptual age, the odds for W/A < P10 were 4.0 times as high in those with a birth weight between 1,000 and 1,499 g and 3.5 times as high in those > 1,500 g. As birth length was reduced, the odds for L/A < P10 increased, but this was not associated with birth weight. The odds for HC/A < P10 were 2.5 times as high in small for gestational age infants. In infants with a body weight < 1,000 g, the odds for HC/A < P10 were 4.4 times higher, compared with those between 1,000 g and 1,499 g and 5.3 times higher if compared with those > 1,500 g. CONCLUSION: At a corrected age of one year, preterm infants with a birth weight < 2,000 g were found with high growth deficits frequencies, and associated factors were variable, depending on the analyzed deficit, with intrauterine and postnatal growth restriction being outstanding predictors.
- ItemSomente MetadadadosPremature infants with birth weights of 1500-1999 g exhibit considerable delays in several developmental areas(Wiley-Blackwell, 2014-01-01) Guerra, Camila C. [UNIFESP]; Moraes Barros, Marina C. de [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; Fernandes, Luciana V. [UNIFESP]; Kopelman, Benjamin I. [UNIFESP]; Santos, Amelia M. N. dos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)AimTo establish the prevalence and factors associated with developmental scores and delays in premature infants.MethodsA cross-sectional study was conducted on 100 premature infants with corrected ages of 18-24months (actual ages 19.92.0months) and birth weights of 1500-1999g. Bayley III scales were used to assess developmental scores, percentage of children with developmental scores <85, factors associated with developmental scores and delays in at least one developmental domain.ResultsThe percentages and 95% confidence intervals of those children with developmental delays were as follows: cognitive (2.0%; 0.6-7.0%), language (5.0%; 2.2-11.2%), motor (3.0%; 1.0-8.5%), socio-emotional (13.0%; 7.8-20.1%), general adaptive (26.0%; 18.4-35.4%), conceptual (17.0%; 10.9-25.6%), social (46.0%; 36.6-55.7%) and practical (21.0%; 14.2-30.0%). Factors associated with delay in at least one developmental domain were as follows: caesarean delivery, low per capita income and peri-intraventricular haemorrhage. Factors associated with a reduction in developmental scores were as follows: non-white ethnicity, lower social class, caesarean delivery, male gender, peri-intraventricular haemorrhage, mechanical ventilation and length of hospitalisation.ConclusionPremature infants with birth weights of 1500-1999g exhibited considerable delays in several developmental areas. in addition to biological factors, environmental factors contributed to the reduced scores and/or developmental delays.