Estímulos ambientais presentes no domicílio e desenvolvimento neuropsicomotor aos 42 meses de idade de egressos de unidades de terapia intensiva neonatal

Abstract

Infant development is a complex and continuous process resulting from the interaction between biological, genetic and environmental factors, and the home environment has a large and significant importance in this relationship. The aims of this study were to investigate the association between biological factors, obstetric, perinatal, neonatal, postnatal, family structure and environmental stimulus present in the home with the cognitive, motor and language development of children from Neonatal Intensive Care Units (NICU) and to investigate how the development-environment interaction is affected by different risk factors. This is a transversal study from the NICU discharges, with a random sample 51 preschool children, who wore evaluated at 42 months of age with the Bayley Scales of Infant and Toddler Development – Third Edition (BAYLEY–III) and the questionnaire Affordances in the Home Environment for Motor Development (AHEMD). Descriptive statistical analysis was performed and Mann-Whitney test was used to investigate the association between variables. The majority of the study participants showed development within normal limits in the BAYLEY-III scale, cognitive performance was found slightly or significantly lower by almost a quarter of these (23.5%). In total classification AHEMD, a "average level" of environmental stimulus opportunities was found in more than two thirds of participants (74.7%), and only 7.8% had "high level" of stimulus. The home environment seems to be associated with the cognitive development (p=0.076) and the "external space of the home" with the language development (p=0.056). Significant associations were found between the subscales of the AHEMD "thick motor materials" and "fine motor materials" with cognitive development (p=0.007 and p=0.047, respectively) and the language (p=0.005 and p=0.001, respectively). Associations were found between some biological, perinatal, neonatal, postnatal risk factors and family structure with neurodevelopment and associations of these development-environment interaction. It was concluded that the amount and variety of opportunities in their home environment are associate with the cognitive and language development at 42 months of NICU and that these stimulus can minimize the undesirable effects of some risk factors on cognitive development in the future.