Avaliação neurológica pelo método Dubowitz em recém-nascidos prematuros com idade corrigida de termo comparada a de nascidos a termo

OBJECTIVE: To compare neonatal neurological assessment of preterm newborn infants at term corrected age with term infants, and to identify the presence of association between neurologic abnormalities in preterm infants and demographic characteristics and neonatal clinical conditions. METHODS: This c...

ver descrição completa

Detalhes bibliográficos
Autores: Golin, Marina Ortega, Souza, Fabíola Isabel S. de, Sarni, Roseli Oselka Saccardo [UNIFESP]
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:Brasil
Recursos:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:portugués
OAI Identifier:oai:repositorio.unifesp.br:11600/5371
Acesso em linha:http://dx.doi.org/10.1590/S0103-05822009000400009
http://repositorio.unifesp.br/handle/11600/5371
Access Level:acceso abierto
Palavra-chave:neurologic examination
infant, newborn
infant, premature
developmental disabilities
exame neurológico
recém-nascido
prematuro
deficiências do desenvolvimento
Descrição
Resumo:OBJECTIVE: To compare neonatal neurological assessment of preterm newborn infants at term corrected age with term infants, and to identify the presence of association between neurologic abnormalities in preterm infants and demographic characteristics and neonatal clinical conditions. METHODS: This cross-sectional study enrolled 60 term and 30 preterm infants born at the Mario Covas State Hospital in Santo André, São Paulo, Brazil. The Dubowitz method was applied to assess neurobehavior. The total score cut-offs of 30.5 and 26 were used to compare respectively preterm and term infants and to analyze the variables related to performance in the preterm group. Preterm newborns were evaluated at 37 post-conceptual weeks and the control group was evaluated 48 hours after birth. All newborns were evaluated by the same neurologist, between feedings and at sleep-awake stages 4 or 5. Statistical analysis was performed by association tests. RESULTS: 90% of the preterm infants did not reach the expected score for term age. Underachievement was seen mainly in the domains of muscle tonus, type of muscle tonus and movements. Among the 30 preterm infants included in the study, 57% did not reach a total score > 26. Sepsis was the only complication significantly associated with neurological impairment (p=0.009). CONCLUSION: Preterm newborn infants at 37 weeks corrected age do not accomplish the neurologic performance of term infants. Sepsis was the only clinical variable associated with neurological disabilities.