Relationship between very low birth weight, environmental factors, and motor and cognitive development of children of 5 and 6 years old / Relação entre muito baixo peso ao nascimento, fatores ambientais e o desenvolvimento motor e o cognitivo de crianças aos 5 e 6 anos

ABSTRACT

OBJECTIVE: To examine the relationships between birth weight, preterm birth, environmental factors and the motor and cognitive development of 5 to 6 year-old children. METHODS: A case control study in which the motor and cognitive performance, as well as the home environment of children aged 5-6 years, born pre-term and weighing <1.500 grams, were compared to peers born full-term and with normal weight. The following testes were used Movement Assessment Battery for Children (MABC), the Developmental Coordination Disorder Questionnaire (DCDQ), the vocabulary and cube tests of the Weschsler Intelligence Test for Children-III (WISC), the Swanson, Nolan and Pelham IV Scale (SNAP IV) and the Home Observation for Measurement of the Environment (HOME). RESULTS: 50.54 percent of the very low birth weight (VLBW) children died and 15.2 percent of them demonstrated severe impairments. The scores (±SD) of the VLBW and normal birth weight (NBW) groups were HOME 33.83±7.81(VLBW), 39.61±8.75(NBW); MABC 8.17±7,10(VLBW), 3.06±3.80(NBW); DCDQ 54.0±11.3(VLBW), 63.0±7.5(NBW); WISC Cubes 8.35±2.15(VLBW), 10.57±2.25(NBW); WISC Vocabulary 9.61±2.62(VLBW), 13.48±2.45(NBW); SNAP IV 4.04±4.95(VLBW), 1.57±3.27(NBW). Significant differences between the groups were found, with higher scores on all measures for the NBW group. The results of the motor and cognitive tests demonstrated correlations with birth weight (p<0.01) and HOME scores (p<0.05). CONCLUSIONS:The findings reaffirmed the evidences that children born pre-term and with VLBW were more vulnerable to have motor and cognitive impairments, compared to those born full-term. Environmental factors appeared to interfere with development of these children.

RESUMO

OBJETIVO: Examinar as relações entre baixo peso ao nascimento, prematuridade, fatores ambientais e os desenvolvimentos motor e cognitivo de crianças aos 5 e 6 anos de idade. MÉTODOS: Estudo caso-controle no qual os desempenhos motor e cognitivo e o ambiente domiciliar de crianças com idade de 5-6 anos, nascidas pré-termo e com peso < 1.500 gramas, foram comparados com os de pares nascidos a termo e com peso adequado (PA). Foram utilizados os testes Movement Assessment Battery for Children (MABC), Developmental Coordination Disorder Questionnaire (DCDQ), as provas de vocabulário e de cubos do Weschsler Intelligence Test for Children-III (WISC), o Swanson, Nolan and Pelham IV Scale (SNAP IV) e o Observation for Measurement of the Environment (HOME). RESULTADOS: 50,54 por cento das crianças nascidas com muito baixo peso (MBP) foram a óbito, e 15,2 por cento deste grupo desenvolveram sequelas severas. Os escores para os grupos de MBP e de PA foram HOME 33,83±7,81(MBP), 39,61±8,75(PA); MABC 8,17±7,10(MBP), 3,06±3,80(PA); DCDQ 54,0±11,3(MBP), 63,0±7,5(PA); WISC Cubos 8,35±2,15(MBP), 10,57±2,25(PA); WISC Vocabulário 9,61±2,62(MBP), 13,48±2,45(PA); SNAP IV 4,04±4,95(MBP), 1,57±3,27(PA). Foram encontradas diferenças significativas entre os grupos, com melhor desempenho em todos os testes no grupo de PA. Os resultados dos testes motores e cognitivos tiveram correlação com o peso ao nascer (p<0,01) e com o HOME (p<0,05). CONCLUSÕES: Os resultados reforçaram as evidências de que crianças nascidas prematuras e de MBP são mais propensas a apresentar dificuldades motoras e cognitivas que seus pares nascidos a termo e de PA. Fatores ambientais parecem interferir no desenvolvimento dessas crianças.