Developmental coordination disorder in preterm children: A systematic review and meta-analysis.

This study aimed to review the prevalence of developmental coordination disorder (DCD) in individuals born preterm and systematically explore this prevalence according to gestational age and different assessment cut-offs and compare it to full-term peers. The eligibility criteria were observational and experimental studies reporting the prevalence of DCD in preterm individuals. A systematic search was performed in databases from inception until March 2022. Two independent reviewers performed the selection. Study quality assessment was performed using the checklists from Joanna Briggs Institute (JBI). Data analysis was performed on Excel and Review Manager Software 5.4. Among the 1774 studies identified, 32 matched the eligibility criteria. The pooled estimate rate of the DCD rate in preterm was 21% (95% confidence interval [CI] 17.8-24.3). The estimate rates were higher as gestational age decreased, and preterm children are two times more likely to have DCD than their full-term peers risk ratio (RR) 2.2 (95% CI 1.77-2.79). The limitation was high heterogeneity between studies; the assessment tools, cut-off points and age at assessment were diverse. This study provided evidence that preterm children are at higher risk for DCD than full-term children, and the risks increased as gestational age decreased.

Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses.

OBJECTIVES: To compare LISA with INSURE technique for surfactant administration in preterm with gestational age (GA) < 36 weeks with RDS in respect to the incidence of pneumothorax, bronchopulmonary dysplasia (BPD), need for mechanical ventilation (MV), regional cerebral oxygen saturation (rSO2), peri­intraventricular hemorrhage (PIVH) and mortality. METHODS: A systematic search in PubMed, Embase, Lilacs, CINAHL, SciELO databases, Brazilian Registry of Randomized Clinical Trials (ReBEC), Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. RCTs evaluating the effects of the LISA technique versus INSURE in preterm infants with gestational age < 36 weeks and that had as outcomes evaluation of the rates of pneumothorax, BPD, need for MV, rSO2, PIVH, and mortality were included in the meta-analysis. Random effects and hazard ratio models were used to combine all study results. Inter-study heterogeneity was assessed using Cochrane Q statistics and Higgin's I2 statistics. RESULTS: Sixteen RCTs published between 2012 and 2020 met the inclusion criteria, a total of 1,944 preterms. Eleven studies showed a shorter duration of MV and CPAP in the LISA group than in INSURE group. Two studies evaluated rSO2 and suggested that LISA and INSURE transiently affect brain autoregulation during surfactant administration. INSURE group had a higher risk for MV in the first 72 h of life, pneumothorax, PIVH and mortality in comparison to the LISA group. CONCLUSION: This systematic review and meta-analyses provided evidence for the benefits of the LISA technique in the treatment of RDS, decreasing CPAP time, need for MV, BPD, pneumothorax, PIVH, and mortality when compared to INSURE.

Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses

Abstract Objectives To compare LISA with INSURE technique for surfactant administration in preterm with gestational age (GA) < 36 weeks with RDS in respect to the incidence of pneumothorax, bronchopulmonary dysplasia (BPD), need for mechanical ventilation (MV), regional cerebral oxygen saturation (rSO2), peri‑intraventricular hemorrhage (PIVH) and mortality. Methods A systematic search in PubMed, Embase, Lilacs, CINAHL, SciELO databases, Brazilian Registry of Randomized Clinical Trials (ReBEC), Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. RCTs evaluating the effects of the LISA technique versus INSURE in preterm infants with gestational age < 36 weeks and that had as outcomes evaluation of the rates of pneumothorax, BPD, need for MV, rSO2, PIVH, and mortality were included in the meta-analysis. Random effects and hazard ratio models were used to combine all study results. Inter-study heterogeneity was assessed using Cochrane Q statistics and Higgin's I2 statistics. Results Sixteen RCTs published between 2012 and 2020 met the inclusion criteria, a total of 1,944 preterms. Eleven studies showed a shorter duration of MV and CPAP in the LISA group than in INSURE group. Two studies evaluated rSO2 and suggested that LISA and INSURE transiently affect brain autoregulation during surfactant administration. INSURE group had a higher risk for MV in the first 72 h of life, pneumothorax, PIVH and mortality in comparison to the LISA group. Conclusion This systematic review and meta-analyses provided evidence for the benefits of the LISA technique in the treatment of RDS, decreasing CPAP time, need for MV, BPD, pneumothorax, PIVH, and mortality when compared to INSURE.

Bioactive compounds recovery by freeze concentration process from winemaking by-product.

Grape pomace is the main solid residue of wine industry, containing high amounts of phenolic compounds. Considering its high potential, an extraction procedure was optimized for maximal recovery of anthocyanins from grape pomace (Vitis vinifera L.) using citric acid as a generally recognized as safe (GRAS) acidulant in water. Volume of solvent (3.2-36.8 mL), time (14.4-165.6 min) and pH of solvent (1.12-4.48) were the studied variables. Furthermore, the best condition to obtain extract rich in anthocyanins was submitted to the gravitational block freeze concentration process. The performance of the process was evaluated and cryoconcentrated and ice fractions were analyzed for physicochemical properties, bioactive compounds content, and antioxidant activity. Interaction, linear, and quadratic effects for volume and pH of solvent were significant by analysis of variance (ANOVA). The experimental design allowed the prediction for maximal recovery of anthocyanins (10 mL of solvent at pH 1.8). The bioactive composition of the optimized grape pomace extract was influenced by the cryoconcentration process. After three cycles using gravitational block freeze concentration, the total phenolics and monomeric anthocyanins were approximately 4 and 5 times higher than the initial condition of the extract, respectively. Consequently, an increase in antioxidant activity was observed. The increase in the concentration of bioactive compounds reached a process efficiency of 93% (stage 1) for phenolic compounds and 91% (stage 2) for anthocyanins. Therefore, the final water-based optimized method is safe and has a low cost and the concentrated extract certainly showed higher concentrations of total phenolics and anthocyanins, compared to the initial extract. The proposed clean extraction method and cryoconcentration technique can be considered important strategies for recovering and valuing grape pomace components, improving the approach to the circular economy concept in the wine industry.

Changes in phytochemical composition of Merlot grape and wine induced by the direct application of boron.

In this study the effect of the direct application of different concentrations of boron in grape bunches on the phytochemical composition of grapes and wine was evaluated. The experiment was carried out by direct application to the grape bunch of different concentrations (0, 1.0, 2.0, 4.0 and 8.0 g/L) of boron solution, in two consecutive vintages, 2018 and 2019. The wines were elaborated by the same microvinification method. Histological analyzes by optical microscopy and phenolic profile by HPLC-DAD were performed on the grapes. The wines were analyzed by HPLC-DAD and ICP-MS for phenolic profile and elemental composition, respectively. Histological analyzes of the grape skin showed an increase in the presence of polyphenols in the cellular tissue of grapes treated with different concentrations of boron when compared to the control samples in both vintages. The addition of boron influenced the phenolic profile of the grapes, resulting in an increase in the content of anthocyanins and flavanols. Regarding to wines, the treatment of grapes by direct application of boron significantly influenced the chemical composition of wines. In 2018, the application of 2 g/L of boron showed a significant increase in the concentration of malvidin and delphinidin in wines. The application of 1 g/L showed the highest concentration of malvidin, delphinidin and peonidin in the 2019 vintage. The boron content increased in the wine samples according to the boron concentrations applied to the grape. Thus, it is possible to produce chemically distinct wines with the direct application of boron to the grapes.

Risk Factors for cognitive, motor and language development of preterm children in the first year of life / Fatores de risco para o desenvolvimento cognitivo, motor e de linguagem ao longo do primeiro ano de vida de crianças nascidas prematuras

Abstract Objective: To perform a longitudinal investigation of risk factors in premature infants' cognitive, motor, and language development. Methods: Thirty-three preterm infants were assessed at 4, 8, and 12 months of corrected age, using the Bayley-III Scales. Parents completed questionnaires regarding development opportunities at home, parenting practices and knowledge. Results: Significant associations were found (1) at 4-months between cognitive scores and family income, variety of stimuli, availability of toys, parenting practices and knowledge; language and parenting practices; and motor skills and parenting practices; (2) at 8-months between cognitive score and length of stay in the Neonatal Intensive Care Unit (NICU), gestational age, birth weight, toys, and parenting knowledge; language and toys; and motor skills and toys and parenting knowledge; (3) at 12-months between cognitive scores and length of stay in the NICU, family income, breastfeeding, toys, and parenting knowledge; language and income and toys; and motor scores and length of stay in the NICU, gestational age, income, stimuli, toys, and parenting knowledge. Regression analyses indicated that: for (1) cognitive development, stimulus variety explained 72% of the model variance at 4 months of age; time at the NICU explained 67 and 43% at 8 and 12 months of age, respectively, and breastfeeding time explained 41% of the model variance at 12 months; (2) for language development, family income explained 42% of the model variance at 12 months; and for motor development (3), time at the NICU explained 80% of the model variance at 12 months. Conclusions: The development over the first year of life is not explained by the severity of birth conditions and associated morbidities only, but also by parenting practices.

RESUMO Objetivo: Investigar longitudinalmente os fatores de risco no desenvolvimento cognitivo, motor e de linguagem de prematuros. Métodos: Participaram 33 crianças prematuras avaliadas aos quatro, oito e 12 meses de idade corrigida, com as escalas Bayley III. Os pais completaram questionários referentes às oportunidades do lar, práticas e conhecimento parentais. Resultados: Associações significantes foram encontradas: (1) aos quatro meses, entre os escores cognitivos e renda familiar, variedade de estímulos, disponibilidade de brinquedos, práticas e conhecimento parental; e linguagem e motor com conhecimento parental; (2) aos oito meses, entre os escores cognitivos e tempo de Unidade de Terapia Intensiva (UTI), idade gestacional, peso ao nascer, brinquedos e conhecimento parental; linguagem e brinquedos; e motor e brinquedos e conhecimento parental; (3) aos 12 meses, entre os escores cognitivos com o tempo de UTI, renda, meses de amamentação, brinquedos e conhecimento parental; linguagem e renda e brinquedos; e motor e idade gestacional, tempo de UTI, renda, estimulação, brinquedos e conhecimento parental. Análises de regressão indicaram que: para o desenvolvimento (1) cognitivo, a variedade de estímulos explicou 72% da variância do modelo aos quatro meses; o tempo de UTI explicou 67 e 43% aos oito e 12 meses respectivamente, e o tempo de amamentação explicou 41% da variância do modelo aos 12 meses; (2) para o desenvolvimento da linguagem, a renda familiar explicou 42% da variância do modelo aos 12 meses; e para o desenvolvimento (3) motor, o tempo de UTI explicou 80% da variância do modelo aos 12 meses. Conclusões: O desenvolvimento no primeiro ano de vida não é explicado apenas pela gravidade ao nascer e pelas morbidades clínicas associadas, mas também pelas práticas parentais.

Motor development in the first year of life predicts impairments in cognition and language at 3 years old in a Brazilian preterm cohort of low-income families.

Purpose: Early identification of impairments is crucial to providing better care for preterm children, especially those from low-income families. The early motor assessment is the first step in monitoring their neurodevelopment. This study investigates if motor development in the first year of life predicts impairments in cognition and language at 3-year-old in a Brazilian preterm cohort. Materials and methods: Data were collected in a follow-up clinic for high-risk infants. The Bayley Scales were used to assess children at 4, 8, 12, and 36 months of age, considering composite scores. Cognitive and language impairments were considered if scores were ≤85. Children (N = 70) were assessed at 4 and 36 months, 79 were assessed at 8 and 36 months, and 80 were assessed at 12 and 36 months. Logistic regressions were used to analyze the predictability of cognitive and language impairments, and receiver-operating characteristics (ROC) curves were used to analyze the sensibility and specificity of motor assessment and cognitive and language impairments. Results: Poor motor scores at 8 and 12 months increased the chances of cognitive and language impairment at 3-year-old. The chance of cognitive impairment at 3-year-old increases by 6-7% for each point that the motor composite score decreases, and the chance of language impairment at 3-year-old increases by 4-5% for each point that the motor composite score decreases. No-significant results were found at 4-months. Adequate sensibility and specificity were found for language impairments considering 12 months scores and for cognitive impairments as soon as 8 months scores. Conclusion: Monitoring preterm motor development in the first year of life helps to identify preterm children at risk for impairment in other developmental domains. Since preterm children from low-income families tend to demonstrate poorer neurodevelopment outcomes, these children need early assessment and referral to intervention to prevent school failures and support from public policies.

Risk Factors for cognitive, motor and language development of preterm children in the first year of life.

OBJECTIVE: To perform a longitudinal investigation of risk factors in premature infants' cognitive, motor, and language development. METHODS: Thirty-three preterm infants were assessed at 4, 8, and 12 months of corrected age, using the Bayley-III Scales. Parents completed questionnaires regarding development opportunities at home, parenting practices and knowledge. RESULTS: Significant associations were found (1) at 4-months between cognitive scores and family income, variety of stimuli, availability of toys, parenting practices and knowledge; language and parenting practices; and motor skills and parenting practices; (2) at 8-months between cognitive score and length of stay in the Neonatal Intensive Care Unit (NICU), gestational age, birth weight, toys, and parenting knowledge; language and toys; and motor skills and toys and parenting knowledge; (3) at 12-months between cognitive scores and length of stay in the NICU, family income, breastfeeding, toys, and parenting knowledge; language and income and toys; and motor scores and length of stay in the NICU, gestational age, income, stimuli, toys, and parenting knowledge. Regression analyses indicated that: for (1) cognitive development, stimulus variety explained 72% of the model variance at 4 months of age; time at the NICU explained 67 and 43% at 8 and 12 months of age, respectively, and breastfeeding time explained 41% of the model variance at 12 months; (2) for language development, family income explained 42% of the model variance at 12 months; and for motor development (3), time at the NICU explained 80% of the model variance at 12 months. CONCLUSIONS: The development over the first year of life is not explained by the severity of birth conditions and associated morbidities only, but also by parenting practices.

Early Detection of Cognitive, Language, and Motor Delays for Low-Income Preterm Infants: A Brazilian Cohort Longitudinal Study on Infant Neurodevelopment and Maternal Practice.

Aim: This study examined the neurodevelopment trajectories, the prevalence of delays, and the risks and protective factors (adverse outcomes, environment, and maternal factors) associated with cognitive, motor, and language development for preterm infants from 4- to 24-months. Method: We assessed 186 preterm infants (24.7% extremely preterm; 54.8% very preterm; 20.4% moderate/late preterm) from 4- to 24-months using the Bayley Scales of Infant Development - III. Maternal practices and knowledge were assessed using the Daily Activities of Infant Scale and the Knowledge of Infant Development Inventory. Birth risks and adverse outcomes were obtained from infant medical profiles. Results: A high prevalence of delays was found; red flags for delays at 24-months were detected at 4- and 8-months of age. The neurodevelopmental trajectories showed steady scores across time for cognitive composite scores for extremely- and very-preterm infants and for language composite scores for the extremely- and moderate/late-preterm; a similar trend was observed for the motor trajectories of moderate/late preterm. Changes over time were restricted to motor composite scores for extremely- and very-preterm infants and for cognitive composite scores for moderate/late preterm; declines, stabilization, and improvements were observed longitudinally. Positive, strong, and significant correlations were for the neurodevelopment scores at the first year of life and later neurodevelopment at 18 and 24 months. The cognitive, language, and motor composite scores of extremely and very preterm groups were associated with more risk factors (adverse outcomes, environment, and maternal factors). However, for moderate/late preterm infants, only APGAR and maternal practices significantly explained the variance in neurodevelopment. Discussion: Although adverse outcomes were strongly associated with infant neurodevelopment, the environment and the parents' engagement in play and breastfeeding were protective factors for most preterm infants. Intervention strategies for preterm infants should start at 4- to 8-months of age to prevent unwanted outcomes later in life.

Neonatal Adverse Outcomes, Neonatal Birth Risks, and Socioeconomic Status: Combined Influence on Preterm Infants' Cognitive, Language, and Motor Development in Brazil.

BACKGROUND: This study extended previous research by investigating the combined effects of neonatal birth risks, neonatal adverse outcomes, and socioeconomic status on preterm neurodevelopment. METHOD: A total of 184 preterm infants were assessed using the Bayley Scales of Infant Development III in a follow-up clinic in southern Brazil. Structural equation modeling was conducted with 3 latent variables (neonatal birth risks, neonatal adverse outcomes, and socioeconomic status) and 3 outcomes (cognitive, language, and motor development). RESULTS: The analyses showed that neonatal adverse outcomes were associated with infants' cognitive (b = -0.45, P < .001), language (b = -0.23, P = .001), and motor (b = -0.51, P < .001) development. Socioeconomic status also explained the variances (cognitive: b = 0.20, P = .006; language: b = 0.28, P = .001; and motor: b = 0.21, P = .004), whereas neonatal birth risks remained significant only in the motor development (b = 0.15, P = .040). CONCLUSION: This study suggests that the most evident contributors to poor neurodevelopment were adverse outcomes and socioeconomic risk factors.

Changes in vineyard productive attributes and phytochemical composition of sauvignon blanc grape and wine induced by the application of silicon and calcium.

BACKGROUND: It is important to increase productivity and improve plant quality at the same time as preserving the principles of safety and productivity. The present study aimed to evaluate the effects of different concentrations of sodium metasilicate and calcium chloride, applied as fertilizers, on the productivity and phytochemical characteristics of Sauvignon Blanc grapes and their respective wines. RESULTS: The experiments were conducted using 2017 and 2018 vintages of commercial Sauvignon Blanc grapes. The treatments consisted of applying separately different concentrations of sodium metasilicate (0, 4, 8 and 12 g L-1 ) or calcium chloride (0, 5, 10 and 15 g L-1 ). The treatments were carried out during four phenological phases. The grapes were harvested at technical maturity and white wines were elaborated. The application of inorganic salts, silicon and calcium to the grapes had a significant effect on the vineyard productivity. The best results were obtained with 4 and 8 g L-1 silicon and 15 g L-1 calcium. An increase in the concentration of phenolics in the grapes was noted. These compounds have antioxidant capacity, which is one of the factors responsible for the resistance of the grapes to pathogens. CONCLUSION: The application of 4 and 8 g L-1 silicon and 15 g L-1 calcium to the grapes represents a potential alternative fertilizing strategy, which could increase the plant yield without damaging the phytochemical characteristics of the fruit and its derivatives. © 2020 Society of Chemical Industry.

Changes in organic acids, polyphenolic and elemental composition of rosé sparkling wines treated with mannoproteins during over-lees aging.

The effect of mannoproteins on the evolution of rosé sparkling wines during over-lees aging was investigated on the basis of the chemical characterization of polyphenols, organic acids, macro- and microelements using a combined analytical approach. Variations on these constituents were assessed using Raman and near-infrared spectroscopy. During the biological aging, caffeic acid, catechin, gallic acid and malvidin-3-O-glucoside were the most abundant polyphenolics in the rosé wines. The phenolic compound tyrosol, a fermentation derivative, was found at concentrations up to 98.07 mg L-1. The addition of mannoproteins significantly affected the concentrations of organic acids and individual polyphenolic compounds, particularly trans-resveratrol, quercetin, catechin, p-coumaric and hydroxybenzoic acids that showed increased concentrations over time. The positive effects of mannoproteins were mainly observed at the end of the biological aging. The mineral composition remained stable, while potassium was the most abundant mineral in all wines. The observed changes involving these constituents may offer new insights on their behavior during wine aging and on the bioactive and nutritional quality of rosé sparkling wines.

Rosé Sparkling Wines: Influence of Winemaking Practices on the Phytochemical Polyphenol During Aging on Lees and Commercial Storage.

The effects of oenological agents, gum arabic, and oenological tannin, added at two different stages in the winemaking of rosé sparkling wines (addition to the base wine and to the sparkling wine after disgorging) on evolution of the phytochemical composition during aging on lees and commercial storage were studied for the first time. The sparkling wines were monitored during 12 months of aging on lees (sur lie, with lees) and commercial storage (bottle storage, without lees), in terms of the polyphenolics, color intensity and antioxidant capacity. It was observed that the stage of the addition of oenological agents influenced the changes in phytochemical polyphenols and antioxidant capacity of sparkling wines. The most notable effects on the polyphenolics were observed in the experiment with the addition of oenological agents to the base wine, which significantly increased the concentrations of trans-resveratrol, gallic and ellagic acids, catechin, quercetin, and myricetin. The addition of oenological agents after the disgorging stage had less influence on the phenolics of the sparkling wines. Caffeic acid, trans-caftaric acid, catechin, tyrosol, and gallic acid were the most abundant polyphenolics in rosé sparkling wines. The winemaking practices evaluated in this study comprise an interesting approach to the improvement and/or maintenance of the polyphenolics, according to winemaking practices, besides providing new knowledge on the evolution of rosé sparkling wines. PRACTICAL APPLICATIONS: Tannins and gum arabic are been described as oenological agents, however, are poorly explored in rosé sparkling wines. Many chemical modifications that occur during the winemaking process, especially due to the second in-bottle fermentation and the yeast contact in the case of sparkling wines, can be determinant of authenticity and quality of sparkling wines. The addition of oenological agents in different stages of the winemaking can provide new insights into the evolution of phytochemical constituents of rosé sparkling wines and draw perspectives for improving technological properties of these wines based on practical experience.

Intervenção cognitivo-motora no ambiente hospitalar: impacto no desenvolvimento motor e cognitivo de infantes com fibrose cística / Cognitive-motor intervention in hospital environment: impact on the motor and cognitive development of infants with cystic fibrosis

Introdução: Em períodos de internação, as experiências vividas pelas crianças podem se mostrar desfavoráveis ao desenvolvimento. Programas interventivos compensatórios podem minimizar esses riscos. Objetivo: Analisar o impacto de uma intervenção cognitivo-motora no desenvolvimento cognitivo e motor de bebês hospitalizados com diagnóstico de fibrose cística. Material e métodos: Participaram do grupo interventivo (GI) seis bebês com diagnóstico de fibrose cística internados em unidade pediátrica de um hospital universitário. O grupo controle foi composto por bebês saudáveis pareados com o GI por idade gestacional, idade, sexo e renda familiar. Os dois grupos foram avaliados com a Alberta Infant Motor Scale (AIMS) no pré e pós-intervenção; e, a Bayley Scales of Infant Development (BSID-III) foi utilizada para avaliar os bebês do GI. Resultados: O GI apresentou escores motores inferiores ao GC no préintervenção e desenvolvimento semelhante no pós-intervenção. Mudanças positivas e significantes foram observadas para o GI no desenvolvimento motor amplo (AIMS: p = 0,026; BSID-III: p = 0,042) e fino (BSID-III: p = 0,043), bem como no percentil de desenvolvimento motor (AIMS: p = 0,043). Conclusão: O impacto da intervenção no ambiente hospitalar foi positivo para o desenvolvimento motor e cognitivo dos bebês com fibrose cística, potencializando e prevenindo descontinuidade no desenvolvimento motor e cognitivo.(AU)

Introduction: During periods of hospitalization the experiences lived by the children may be unfavorable to the development. Compensatory intervention programs may diminish these risks. Objective: To analyze the impact of a cognitive-motor' intervention in the cognitive and motor development of infants hospitalized with a diagnosis of cystic fibrosis. Methods: Participate in the intervention (IG) six infants diagnosed with cystic fibrosis and hospitalized in the pediatric unit of university hospital. The control group (CG) was formed by healthy infants, paired with the IG for gestational age, age, gender and family income. Both groups were assessed using the Alberta Infant Motor Scale (AIMS) at pre- and post-intervention; and the Bayley Scales of Infant Development (BSID-III) was used to assess the IG. Results: GI showed lower motor scores compared to the GC1 at the pre-intervention and similar scores at the post-intervention. Positive and significant changes were observed for the gross (AIMS: p = 0.026; BSID-III: p = 0,042) and fine (BSID-III: p = 0,043) motor development, as well for the motor development percentile (AIMS: p = 0.043). Conclusion: The intervention had positive impact in the motor and cognitive development of babies with cystic fibrosis, boosting and preventing discontinuities in the motor and cognitive development. (AU)

A intervenção motora como fator de prevenção de atrasos no desenvolvimento motor e cognitivo de bebês durante o período de internação hospitalar / The motor intervention as delays prevention factor in motor and cognitive development of infants during the hospital stay

Introdução: A intervenção cognitivo-motora é benéfica para o desenvolvimento tanto motor como cognitivo do bebê. Essas intervenções, no hospital, têm sido amplamente estudadas dentro de unidades de terapia intensiva neonatal, porém poucos estudos investigam a intervenção avaliando o desenvolvimento infantil dentro de unidades de internação pediátrica. Objetivo: Avaliar o impacto da intervenção cognitivo-motora no desenolvimento motor e cognitivo de bebês de 1 a 18 meses, hospitalizados por doenças respiratórias. Método: Pesquisa quase experimental, na qual participaram 22 bebês internados na unidade pediátrica por doença respiratória, divididos em dois grupos (10 no grupo controle e 12 no grupo intervenção), sem diferenças significativas nos dados biológicos e socioeconômicos. A idade variou de 1 a 16 meses, com média de 5,50 meses (DP ± 4,51). Utilizou-se como instrumento um questionário para caracterização da amostra, a Alberta Infant Motor Scale (AIMS) e a Bayley Scales of Infant Development (BSID-III). A análise dos dados foi feita por meio de estatística descritiva, Teste t de Student, General Linear Model e One Way ANOVA. Resultados: Os resultados evidenciaram interação significativa entre grupo × tempo, nos escores motores e cognitivos. Ao comparar os dois momentos, o grupo intervenção mudou positiva e significativamente do período pré para o pós-intervenção, nos escores motores e cognitivos. O mesmo não ocorreu para o grupo controle. Conclusão: Os resultados sugerem que a intervenção no ambiente hospitalar, durante o tempo de internação de bebês, contribui de forma positiva para o desenvolvimento motor e cognitivo.

Introduction: Cognitive-motor tasks intervention is beneficial for the infant's motor and cognitive development. These interventions in the hospital setting, have been widely studied in neonatal intensive care units, however, few studies evaluate child development within pediatric units. Objective: To evaluate the impact of cognitive-motor intervention in motor and cognitive development of infants hospitalized with respiratory diseases. Method: The research was characterized as quasi-experimental, 22 babies hospitalized in the pediatric unit for respiratory disease were divided into 2 groups (10 in the control group and 12 in the intervention group) without significant differences in biological and socioeconomic data. The mean age was 5.50 months (SD ± 4.51), ranging between 1 and 16 months. Questionnaire was conducted with the infant's parent/guardian for sample characterization. The Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development (BSID-III) was used to evaluate motor e cognitive development. Data analysis was performed using descriptive statistics, Student's t test, General Linear Model and One Way ANOVA. Results: The results show a significant interaction between group time in motor and cognitive scores. When comparing the two times, the intervention group changed positively and significantly from pre- to post-intervention in motor and cognitive scores. The same was not observed for the control group. Conclusion: The results of this study suggest that the intervention during the hospital stay contributes positively to the motor and cognitive development.

A influência da hospitalização no desenvolvimento motor de bebês internados no Hospital de Clínicas de Porto Alegre / The influence of hospitalization on motor development of infants admitted to Hospital de Clínicas de Porto Alegre

Objetivos: Avaliar o desenvolvimento motor de bebês internados no Hospital de Clínicas de Porto Alegre (HCPA) por mais de 30 dias e compará-lo com bebês que não tiveram internações hospitalares anteriores. Método: Estudo transversal e comparativo no qual participaram 12 bebês (entre 4 e 15 meses de idade) divididos em dois grupos pareados de acordo com a idade corrigida e renda familiar: GH – 6 bebês internados pelo período mínimo de 30 dias na Unidade de Internação Pediátrica do HCPA; e GC – 6 grupo controle, bebês provenientes de escolas de educação infantil. Para avaliação do desenvolvimento motor foi utilizada a Escala Motora Infantil de Alberta (EMIA). Resultados: Os bebês do GH apresentaram desempenho motor inferior aos bebês do GC nos escores de todas as posturas, escore bruto, percentil e categorização. Porém, foi verificada diferença estatisticamente significativa apenas para comparação nos valores do percentil da EMIA. No GH, nenhum bebê apresentou desenvolvimento adequado, sendo que 83,3% apresentaram atraso e 16,7% suspeita de atraso; enquanto o GC, 50% dos bebês apresentaram desenvolvimento adequado, 33,3 suspeita de atraso e 16,7% atraso. Conclusão: Os resultados sugerem que a hospitalização influenciou negativamente o desenvolvimento motor dos bebês internados no HCPA. No entanto, o fator hospitalização não deve ser considerado o único responsável pelo comprometimento motor dos lactentes, considerando que outras variáveis podem estar envolvidas e também são apontadas como fatores de risco ao desenvolvimento.

Aims: To assess motor development in infants hospitalized for more than 30 days at Hospital de Clínicas de Porto Alegre (HCPA) and compare it with that of infants with no history of hospitalization. Methods: This is a cross-sectional comparative study. The sample consisted of 12 infants (aged 4 to 15 months) divided into two groups matched for corrected age and family income: HG – 6 infants hospitalized for more than 30 days at HCPA pediatric unit; and CG – 6 control infants from preschools. The Alberta Infant Motor Scale (AIMS) was used to assess motor development. Results: Hospitalized infants had poorer motor performance than control infants in all posture scores, raw score, percentile, and categorization. However, there was a statistically significant difference only for the comparison using AIMS percentile values. No hospitalized infant showed adequate development, 83.3% had developmental delay and 16% suspected developmental delay. In the CG, 50% of infants showed adequate development, 33.3% had suspected developmental delay, and 16.7% had developmental delay. Conclusions: The results suggest that hospitalization had a negative effect on motor development in infants admitted to HCPA. However, hospitalization should not be considered solely responsible for motor impairment in infants, since other variables may also be involved and identified as risk factors for developmental delay.