Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors / Avaliação cognitiva em crianças pré-termo usando Bayley-III: desenvolvimento no primeiro ano de vida e fatores associados

ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.

Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors.

OBJECTIVE: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. METHODS: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. RESULTS: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. CONCLUSIONS: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

Can tactile reactivity in preterm born infants be explained by an immature cortical response to tactile stimulation in the first year? A pilot study.

This study aimed to compare preterm (PT) and full-term (FT) infants' adaptive behavior and functional cortical response to tactile stimulus, as measured by Test of Sensory Functions in Infants and functional Near-Infrared Spectroscopy (fNIRS). Outcome measures were taken at 6 (PT = 26/FT = 21 infants) and 12 months (PT = 15/FT = 14 infants). At 6 months, poorer tactile reactivity was observed in PT, but not confirmed at 12 months. At 6 months, cortical response to tactile stimulus was found in the primary sensorimotor cortex and differences between groups did not reach significance. At 12 months, cortical response was found in the primary sensorimotor cortex and premotor area and in the somatosensory associative area, with significant less frequent response in premotor area in PT. The findings reinforce fNIRS as a tool to complement the knowledge of tactile adaptive behaviors in PT in early life.

SENSORY PROCESSING DURING CHILDHOOD IN PRETERM INFANTS: A SYSTEMATIC REVIEW. / PROCESSAMENTO SENSORIAL NO PERÍODO DA INFÂNCIA EM CRIANÇAS NASCIDAS PRÉ-TERMO: REVISÃO SISTEMÁTICA.

OBJECTIVE: To conduct a systematic search for grounded and quality evidence of sensory processing in preterm infants during childhood. DATA SOURCE: The search of the available literature on the theme was held in the following electronic databases: Medical Literature Analysis and Retrieval System Online (Medline)/PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs)/Virtual Library in Health (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus, and Web of Science. We included only original indexed studies with a quantitative approach, which were available in full text on digital media, published in Portuguese, English, or Spanish between 2005 and 2015, involving children aged 0-9years. DATA SYNTHESIS: 581 articles were identified and eight were included. Six studies (75%) found high frequency of dysfunction in sensory processing in preterm infants. The association of sensory processing with developmental outcomes was observed in three studies (37.5%). The association of sensory processing with neonatal characteristics was observed in five studies (62.5%), and the sensory processing results are often associated with gestational age, male gender, and white matter lesions. CONCLUSIONS: The current literature suggests that preterm birth affects the sensory processing, negatively. Gestational age, male gender, and white matter lesions appear as risk factors for sensoryprocessing disorders in preterm infants. The impairment in the ability to receivesensory inputs, to integrateand to adapt to them seems to have a negative effect on motor, cognitive, and language development of these children. We highlight the feasibility of identifying sensory processing disorders early in life, favoring early clinical interventions.

OBJETIVO: Buscar sistematicamente evidências fundamentadas e de qualidade sobre o processamento sensorial em crianças nascidas pré-termo no período da infância. FONTES DE DADOS: A busca da literatura disponível sobre o tema foi realizada nas bases de dados eletrônicas Sistema Online de Busca e Análise de Literatura Médica (Medline)/PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs)/Biblioteca Virtual em Saúde (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus e Web of Science. Foram incluídos estudos indexados, originais, quantitativos e disponíveis na íntegra em meio digital, publicados em português, inglês ou espanhol, entre 2005 e 2015, envolvendo crianças entre zero e 9 anos de idade. SÍNTESE DOS DADOS: A busca identificou 581 artigos, e oito foram incluídos conforme critérios de elegibilidade. Destes, seis estudos (75%) encontraram alta frequência de processamento sensorial alterado em crianças pré-termo. A associação entre processamento sensorial e desfechos de desenvolvimento foi observada em três estudos (37,5%). Verificou-se associação entre processamento sensorial e características neonatais em cinco estudos (62,5%). Os resultados de processamento sensorial frequentemente se associam a idade gestacional, sexo masculino e lesões da substância branca. CONCLUSÕES: Análise da literatura atual sugere que prematuridade tem impacto negativo no processamento sensorial. Idade gestacional, sexo masculino e lesões de substância branca aparecem como fatores de risco para alterações de processamento sensorial em crianças nascidas pré-termo. O prejuízo na capacidade de receber informações sensoriais, de integrar e de adaptar-se a elas parece interferir negativamente no desenvolvimento motor, cognitivo e de linguagem dessas crianças. Destaca-se a viabilidade da identificação das alterações de processamento sensorial nos primeiros anos de vida, favorecendo o encaminhamento precoce para intervenções clínicas.

PROCESSAMENTO SENSORIAL NO PERÍODO DA INFÂNCIA EM CRIANÇAS NASCIDAS PRÉ-TERMO: REVISÃO SISTEMÁTICA / SENSORY PROCESSING DURING CHILDHOOD IN PRETERM INFANTS: A SYSTEMATIC REVIEW

RESUMO Objetivo: Buscar sistematicamente evidências fundamentadas e de qualidade sobre o processamento sensorial em crianças nascidas pré-termo no período da infância. Fontes de dados: A busca da literatura disponível sobre o tema foi realizada nas bases de dados eletrônicas Sistema Online de Busca e Análise de Literatura Médica (Medline)/PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs)/Biblioteca Virtual em Saúde (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus e Web of Science. Foram incluídos estudos indexados, originais, quantitativos e disponíveis na íntegra em meio digital, publicados em português, inglês ou espanhol, entre 2005 e 2015, envolvendo crianças entre zero e 9 anos de idade. Síntese dos dados: A busca identificou 581 artigos, e oito foram incluídos conforme critérios de elegibilidade. Destes, seis estudos (75%) encontraram alta frequência de processamento sensorial alterado em crianças pré-termo. A associação entre processamento sensorial e desfechos de desenvolvimento foi observada em três estudos (37,5%). Verificou-se associação entre processamento sensorial e características neonatais em cinco estudos (62,5%). Os resultados de processamento sensorial frequentemente se associam a idade gestacional, sexo masculino e lesões da substância branca. Conclusões: Análise da literatura atual sugere que prematuridade tem impacto negativo no processamento sensorial. Idade gestacional, sexo masculino e lesões de substância branca aparecem como fatores de risco para alterações de processamento sensorial em crianças nascidas pré-termo. O prejuízo na capacidade de receber informações sensoriais, de integrar e de adaptar-se a elas parece interferir negativamente no desenvolvimento motor, cognitivo e de linguagem dessas crianças. Destaca-se a viabilidade da identificação das alterações de processamento sensorial nos primeiros anos de vida, favorecendo o encaminhamento precoce para intervenções clínicas.

ABSTRACT Objective: To conduct a systematic search for grounded and quality evidence of sensory processing in preterm infants during childhood. Data source: The search of the available literature on the theme was held in the following electronic databases: Medical Literature Analysis and Retrieval System Online (Medline)/PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs)/Virtual Library in Health (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus, and Web of Science. We included only original indexed studies with a quantitative approach, which were available in full text on digital media, published in Portuguese, English, or Spanish between 2005 and 2015, involving children aged 0-9years. Data synthesis: 581 articles were identified and eight were included. Six studies (75%) found high frequency of dysfunction in sensory processing in preterm infants. The association of sensory processing with developmental outcomes was observed in three studies (37.5%). The association of sensory processing with neonatal characteristics was observed in five studies (62.5%), and the sensory processing results are often associated with gestational age, male gender, and white matter lesions. Conclusions: The current literature suggests that preterm birth affects the sensory processing, negatively. Gestational age, male gender, and white matter lesions appear as risk factors for sensoryprocessing disorders in preterm infants. The impairment in the ability to receivesensory inputs, to integrateand to adapt to them seems to have a negative effect on motor, cognitive, and language development of these children. We highlight the feasibility of identifying sensory processing disorders early in life, favoring early clinical interventions.

Near-infrared spectroscopy as an auxiliary tool in the study of child development / Espectroscopia de luz próxima ao infravermelho como ferramenta auxiliar no estudo do desenvolvimento infantil

OBJECTIVE: To investigate the applicability of Near-Infrared Spectroscopy (NIRS) for cortical hemodynamic assessment tool as an aid in the study of child development. DATA SOURCE: Search was conducted in the PubMed and Lilacs databases using the following keywords: ''psychomotor performance/child development/growth and development/neurodevelopment/spectroscopy/near-infrared'' and their equivalents in Portuguese and Spanish. The review was performed according to criteria established by Cochrane and search was limited to 2003 to 2013. English, Portuguese and Spanish were included in the search. DATA SYNTHESIS: Of the 484 articles, 19 were selected: 17 cross-sectional and two longitudinal studies, published in non-Brazilian journals. The analyzed articles were grouped in functional and non-functional studies of child development. Functional studies addressed the object processing, social skills development, language and cognitive development. Non-functional studies discussed the relationship between cerebral oxygen saturation and neurological outcomes, and the comparison between the cortical hemodynamic response of preterm and term newborns. CONCLUSIONS: NIRS has become an increasingly feasible alternative and a potentially useful technique for studying functional activity of the infant brain.

OBJETIVO: Investigar a aplicabilidade da espectroscopia de luz próxima ao infravermelho (NIRS) para avaliação da hemodinâmica cortical como ferramenta auxiliar no estudo do desenvolvimento infantil. FONTES DE DADOS: Revisão integrativa de literatura feita nas bases de dados PubMed e Lilacs, a partir da combinação das palavras-chave: "psychomotor performance/child development/growth and development/neurodevelopment/NIRS/spectroscopy/near-infrared" e seus correspondentes em português e espanhol. A pesquisa seguiu protocolo adaptado dos critérios estabelecidos pela Cochrane e teve como limite temporal de 2003 a 2013. Foram incluídas publicações nos idiomas inglês, português e espanhol. SÍNTESE DOS DADOS: Foram localizados 484 artigos, dos quais 19 foram selecionados, 17 transversais e dois longitudinais, todos publicados em periódicos estrangeiros. A análise dos artigos permitiu agrupá-los, quanto à sua abordagem, em estudos funcionais e estudos não funcionais do desenvolvimento infantil. Os estudos funcionais abordaram o processamento de objetos e o desenvolvimento de habilidades sociais, da linguagem e cognitivo. Os estudos não funcionais discutiram a relação entre a saturação de oxigênio cerebral e o desfecho neurológico e a comparação entre a resposta hemodinâmica cortical de recém-nascidos prematuros e a termo. CONCLUSÕES: A NIRS se torna, cada vez mais, uma opção viável e uma técnica potencialmente útil para estudos de atividade funcional do cérebro infantil.

[Near-infrared spectroscopy as an auxiliary tool in the study of child development]. / Espectroscopia de luz próxima ao infravermelho como ferramenta auxiliar no estudo do desenvolvimento infantil.

OBJECTIVE: To investigate the applicability of Near-Infrared Spectroscopy (NIRS) for cortical hemodynamic assessment tool as an aid in the study of child development. DATA SOURCE: Search was conducted in the PubMed and Lilacs databases using the following keywords: "psychomotor performance/child development/growth and development/neurodevelopment/spectroscopy/near-infrared" and their equivalents in Portuguese and Spanish. The review was performed according to criteria established by Cochrane and search was limited to 2003 to 2013. English, Portuguese and Spanish were included in the search. DATA SYNTHESIS: Of the 484 articles, 19 were selected: 17 cross-sectional and two longitudinal studies, published in non-Brazilian journals. The analyzed articles were grouped in functional and non-functional studies of child development. Functional studies addressed the object processing, social skills development, language and cognitive development. Non-functional studies discussed the relationship between cerebral oxygen saturation and neurological outcomes, and the comparison between the cortical hemodynamic response of preterm and term newborns. CONCLUSIONS: NIRS has become an increasingly feasible alternative and a potentially useful technique for studying functional activity of the infant brain.