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ABSTRACT Purpose analyze the effects of hospitalization in the Kangaroo Neonatal Intermediate Care Unit (UCINCa), the second stage of the Kangaroo Care (KC), on the development of oral feeding skills in preterm neonates. Methods an analytical observational study of the prospective longitudinal type, carried out in a public hospital in Southern Brazil, where infants were accompanied until hospital discharge. The sample consisted of 20 preterm neonates hospitalized at the UCINCa and 26 preterm neonates at the Conventional Neonatal Intermediate Care Unit (UCINCo), that were periodically evaluated through the levels of oral skill, in a bottle, according to the criteria of proficiency and milk transfer rate. The outcomes considered were a progression of the oral skill level, days of transition to obtain the full oral route, and days of hospital stay. Results the duration of transition to exclusive oral feeding was shorter for preterm neonates at the UCINCa (4.5 vs. 10 days) relative to those at the UCINCo (p = 0.041). By the third assessment, all preterm neonates at the UCINCa had reached level 4, while participants at the UCINCo only achieved this level of performance on the fifth assessment. The average number of days of hospitalization was four days shorter in UCINCa participants (p=0.098). Conclusion the admission to the UCINCa had been a further acceleration in the maturation of oral skills, which allowed for a faster transition to exclusive oral feeding as compared to neonates admitted in UCINCo.

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Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Preterm newborns hospitalized in a Newborn Intensive Care Unit (NICU) are submitted to daily manipulations and painful procedures and, consequently, many of them suffer with pain, modifying their physiological parameters. Objectives: To evaluate the effects of hydrotherapy in pain and vital signs in preterm newborns hospitalized in the NICU of the Hospital da Cidade de Passo Fundo. Methods: A quantitative, observational, crosssectional and retrospective study using medical records filed in the Physical Therapy Sector of the NICU of the Hospital da Cidade de Passo Fundo. The sample was composed by 57 records of newborns with gestational age below 36 weeks who received aquatic physical therapy, in which were performed several movements in order to normalize the physiological parameters and reduce pain. After exclusion criteria the final sample was 54 patients. Results: Statistically significant results (p<0.05) were obtained in the evaluation of all vital signs, as well as in the use of the NFCS (Neonatal Facial Coding System) scale. The most prevalent diagnoses were hyaline membrane disease (77.8%), low birth weight (72.2%) and extreme prematurity (44.4%). Conclusions: Hydrotherapy has been shown to be effective and safe for reducing pain and improving vital signs of preterm newborns when well indicated. However, further studies in the area are suggested. [ABSTRACT FROM AUTHOR]

Mothers of preterm babies present clinical symptoms of anxiety, turning them more fragile and less adapted to initial care for the baby, with consequences upon the global development of the child along time. This study investigated the self-perception of anxiety of preterm babies’ mothers at birth and six months later and also about correlations between maternal anxiety and babies’ behaviors during the first year of life. Clinical and structured interview with 44 mothers twelve months after hospital discharge. Results reveal a higher level of maternal anxiety at delivery than six months later. It was observed a significant relationship between the feeling of maternal anxiety at delivery and babies’ sleep disturbances during the first year of life. Maternal perception of anxiety at delivery was strongly associated with the intensity of fear displayed by the baby in the presence of strangers. Results suggest that maternal anxiety at delivery influences the beginning of the baby’s play whose skill is inversely proportional to maternal anxiety. Maternal anxiety after delivery seems to influence mother-baby relationship and baby’s behaviors that are indicators of development, inducing a level lower than expected.

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Objective: To analyze economic inequality (absolute and relative) due to family income in relation to the occurrence of preterm births in Southern Brazil. Methods: Four birth cohort studies were conducted in the years 1982, 1993, 2004, and 2011. The main exposure was monthly family income and the primary outcome was preterm birth. The inequalities were calculated using the slope index of inequality and the relative index of inequality, adjusted for maternal skin color, education, age, and marital status. Results: The prevalence of preterm births increased from 5.8% to approximately 14% (p‐trend

Objectives: To assess the finger‐feeding technique when compared with the cup feeding method during the early stage of preterm infant feeding transition regarding milk loss, milk ingestion period, and complications. Methods: Experimental, randomized, prospective study including 53 preterm infants with gestation age 28 points in the Oral Feeding Readiness Assessment Scale. The preterm babies were randomized to be included in the control group, which underwent the feeding transition using a cup or in the experimental group, which used the finger‐feeding technique. The analysis of data was performed using Student's t‐test to evaluate differences between mean values of the appointed variables, and Fischer's test for categorical variables; the asymmetric variables were assessed by the Kruskal–Wallis ANOVA test. Results: When compared with the control group, the experimental group showed lower milk loss, longer milk ingestion time, and a lower frequency of complications during feeding. The significance level was set at 5%, with a confidence interval of 90%. Conclusion: The finger‐feeding technique was shown to be a better feeding transition method regarding efficacy when compared with cup feeding method, due to lower milk loss and fewer complication episodes.

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Objectives: To assess the effect of maternal breast milk supplementation on the development of exclusively breast‐fed very low birth weight preterm infants at 12 months of corrected age. Methods: A randomized clinical trial with 53 infants followed‐up after discharge from the neonatal unit until a corrected gestational age of 12 months. Newborns in the intervention group were breastfed exclusively with maternal milk and received 2 g of a multinutrient supplement (Pré‐Nan®, Nestlé, Vevey, Switzerland) added to expressed breast milk twice a day until a corrected age of 4 to 6 months. The control group was exclusively breastfed without supplementation. After monthly follow‐up, developmental assessment was performed using the Bayley III Scale. Results: There was no statistically significant difference on the Bayley III Scale between the intervention and control groups in any of the assessed domains: motor, cognitive, and communication. However, scores in the three domains were always higher in the group that received the supplement. There were a similar number of cases of developmental delay in both groups: seven (28%) in the group that received the supplement and nine (33.3%) in the group that was exclusively breastfed. Conclusions: The results failed to show an association between post‐discharge multinutrient supplementation and development in the assessed infants.

Objective: to identify the impact of maternal profile on birth outcomes. Method: Descriptive cross-sectional study with a sample of 244 postpartum women, as follows: 109 mothers of preterm infants and 135 mothers of full-term infants. The births occurred in the April-September 2015 period in a public maternity hospital in the Northeastern region of Brazil. Data was analyzed with Statistica 10 software and Chi-square test. Results: high prevalence of sedentary lifestyle; statistical significance for overweight and obesity before and during pregnancy; high prevalence of high blood pressure during the gestational period of mothers of preterm infants. Also, 58.1% (n = 63) of preterm infants were born with health problems and 96.3% (n = 130) of full-term infants were healthy. Conclusion: Maternal obesity and overweight is a risk factor for preterm births, an event that demands child healthcare.

Prematurity has been associated with Autism Spectrum Disorders (ASD), and the early diagnosis is relevant for this population. This study compares the frequency of positive screening for ASD signs using M-CHAT at 18-24 months (n = 60) and ABC questionnaires at 30-36 months (n = 58) of corrected age in toddlers born prematurely with birth weight < 1500g and investigates ASD diagnosis in suspected cases. Toddlers screened positive were evaluated with a DSM-5 diagnostic protocol. 6.7% of toddlers screened positive for M-CHAT and 5.2% for ABC. ASD diagnosis was confirmed for 3.3% of children. An agreement between M-CHAT and ABC questionnaires was low (k = 0.241, p = 0.063). The frequency of suggestive signs of ASD detected by the M-CHAT and the ABC at different moments was similar, and the diagnosis rate of ASD was high. The screening at 18-24 month added to the screening at 30-36 months increased the frequency of positive screening for signs of ASD in preterm. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. Methods: This was a multicentric, cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 – conservative approach (without treatment), G2 – pharmacologic (indomethacin or ibuprofen), G3 – surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. Outcomes: death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t‐test, chi‐squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p‐values < 0.05 were considered statistically significant. Results: 1,097 newborns were selected and 494 newborns were included: G1 ‐ 187 (37.8%), G2 ‐ 205 (41.5%), and G3 ‐ 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) and ROPsur were observed in G3 (23.5%). The lowest occurrence of death/BPD36wks occurred in G2 (58.0%). Pharmacological (OR 0.29; 95% CI: 0.14‐0.62) and conservative (OR 0.34; 95% CI: 0.14‐0.79) treatments were protective for the outcome death/BPD36wks. Conclusion: The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.

Objective: To establish the influence of late‐onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. Method: This was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed‐up at the outpatient follow‐up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early‐onset spesis and cases with more than one pathogen growth in blood cultures. Septic and non‐septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI‐II) at 18 to 24 months of corrected age. Results: 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late‐onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram‐positive infection showed motor deficit when compared to the non‐septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6‐21.8, p = 0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase‐negative Staphylococcus, 21.8% for Gram‐positive bacteria, and 50% for Gram‐negative bacteria and fungi. Conclusion: Neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram‐positive infections are associated with motor deficit.

Introduction: Each year, one in 10 babies are born premature worldwide and are susceptible to osteopenia of prematurity. Osteopenia of prematurity is characterized by alterations in skeletal mineralization due to deficient increase in bone mineral content. Objective: To review, in the current literature, randomized clinical trials on the effects of motor physical therapy in preterm infants in relation to the prevention and/or treatment of prematurity osteopenia, as well as to observe the most used techniques for this assistance. Materials and Methods: This is an integrative review of the literature including randomized clinical trials using motor physiotherapy as intervention techniques. We have searched the main databases (Pubmed, Cochrane Central, Lilacs and PEDro) for studies published from 2005 to 2016, using the descriptors: "premature", "bone mineralization", "physiotherapy", "osteopenia of prematurity" and its equivalents in Portuguese. Results: Seven studies were included and the techniques used were passive mobilizations in the joints of the upper and lower limbs, with soft articular compression and a protocol of tactile-kinesthetic stimulation. Conclusion: Although there are few randomized clinical trials, it was observed that motor physical therapy uses techniques that are effective in weight gain, growth, muscle mass and prevention of the imbalance between the formation and absorption of the bone matrix in premature infants, having an important role in the prevention and treatment of prematurity osteopenia. [ABSTRACT FROM AUTHOR]

Introduction: In the care of preterm newborn, practices that favor the participation of mothers in care are recommended. The use of appropriate instruments by professionals can contribute to strengthen maternal participation. Objective: To analyse the contributions of the use of the Newborn Behavioral Observations (NBO) for the maternal care of preterm neonates Methods: Descriptive qualitative study, using participant observation and semi-structured interviews with 14 mothers of preterm newborns who underwent NBO. Data was submitted to content analysis, assinted by the software MAXQda 12. Results: It was found that the mothers' prior perceptions of the newborn´s capacities or how they react to environmental stimuli do not differ from what was observed and reported by them after NBO. However, it was verified that NBO confirms this perception and broadens the mothers' understanding of the meaning of the newborn's behavior. Participating in the NBO helped the mothers to identify strategies to find the needs of the newborn, qualifying the care already performed by them and opening new possibilities for maternal care. Conclusion: The NBO is an instrument that favors the mother's learning about the behavior of the newborn and contributes to the construction of practices with potential to be used by them within daily care. This allows us to consider it as a tool that favors the mother-baby relationship, contributes to the mother's participation in the care, and supports the mother in the construction of her autonomy for the continuity of the newborn's care after hospital discharge. [ABSTRACT FROM AUTHOR]

Introduction: Preterm infants are vulnerable to developmental delays. Detecting problems at an early age is one of the challenges of professionals and researchers in the area. Objective: To analyse the motor development and to identify the risk factors associated with predictors of overall and motor delay in preterm newborns. Methods: Eighty preterm infants (50% female; mean gestational age = 33 ± 2.2 weeks) with low birth weight (average of 1,715 ± 437 g) were evaluated using the Neurobehavioral Assessment of the Preterm Infant (NAPI) during the neonatal phase (prior to term age), the Denver Developmental Screening Test II (DDST-II) between 2 and 8 months, the Test of Infant Motor Performance between 2 and 4 months regarding motor development and the Alberta Infant Motor Scale between 4 and 8 months. Results: Neurobehavioural delay was noted in 24% of the infants in the neonatal phase. Between 2 and 8 months, the delay in overall development was ≥ 31% and the delay in motor development was 35-36 %. Decreased levels of alertness, orientation, motor development and vigour according to the NAPI were shown to be predictive of a delay in development between 4 and 6 months of age. The delay in overall development between 2 and 6 months was predictive of a delay in motor development between 6 and 8 months. Conclusion: Neurobehavioural variables, hospital stay and overall delay are good predictors of motor development during the first year of age. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to determine the prevalence of psychological distress, depression, anxiety, and stress among postpartum Arab mothers of preterm or low birth weight (LBW) infants and to identify maternal characteristics that can predict psychological distress among mothers of preterm infants. Methods: A hospital-based study was conducted. A representative sample of 2,091 postpartum mothers was surveyed and 1,659 women (79.3%) gave their consent to participate in the study. The study was based on a face-to-face interview with a designed questionnaire covering sociodemographic characteristics, anthropometric measures, medical history, and maternal characteristics. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scale (DASS-21). Results: In the study sample, 10.2% of the postpartum mothers had preterm/LBW infants. Depression (29.4 vs. 17.3%) and anxiety (26.5 vs. 11.6%) were significantly more common among mothers of preterm births compared to mothers of full term infants (p < 0.001). The risk of depression in mothers of preterm/LBW infants was two times the risk in mothers of full term infants, while the risk of anxiety was 2.7 times in mothers of preterm/LBW infants than in mothers of full term infants. Young mothers and those who had less than secondary education (42.0 vs. 21.7%; p = 0.007) and lower monthly household income (72.0 vs. 53.3%; p = 0.024) were more depressed and anxious after the preterm birth when compared with mothers of full term infants. Psychological distress was higher in mothers with history of preterm birth (30.0 vs. 21.7%) and delivery complications (52.0 vs. 33.3%). Conclusions: We found a greater risk of depression and anxiety in mothers of preterm births than in mothers of full term infants. Our analysis revealed that depressed and anxious women of preterm infants were younger, less educated, had a lower body weight and low household income than non-depressed and non-anxious women.

OBJECTIVES: to investigate pre-gestational risk factors for spontaneous preterm birth and, the role of smoking and its cumulative effects on prematurity. METHODS: a case-control study analyzed a data set of all births occurring in a tertiary maternity hospital between April 2002 and July 2004. Spontaneous preterm births of single and live newborns without malformations were selected as cases. Controls were all the term births of live and single newborns without malformations during the same period. Three outcomes were studied: all preterm births (OBJETIVOS: investigar fatores de risco pré-gestacional para nascimento espontâneo prematuro e o papel do tabagismo e seus efeitos cumulativos na prematuridade. MÉTODOS: um estudo transversal baseado em um banco de dados maternos e perinatais, analisou todos os nascimentos ocorridos, em um hospital terciário, no período de abril de 2002 a julho de 2004. Nascimentos prematuros, únicos e espontâneos, de nascidos vivos, sem malformações, foram selecionados como casos. Controles foram selecionados como nascidos vivos e a termo, únicos e sem malformações durante o mesmo período. Três desfechos foram estudados: todos nascimentos prematuros com menos de 37 semanas, aqueles com menos de 35 e 32 semanas de gestação. Regressão Logística foi utilizada na determinação do efeito independente de cada um dos fatores de risco. RESULTADOS: idade materna de menos de 20 anos, baixa escolaridade, baixo índice de massa corporal pré-gestacional e tabagismo se mostraram independente e significativamente associados com nascimento espontâneo e prematuro para os três desfechos. Para todos os fatores de risco, exceto tabagismo materno, as razões de chance aumentaram linearmente com o decréscimo da idade gestacional. O teste para tendência linear se mostrou significante para idade materna de menos de 20 anos e para baixo índice de massa corporal pré-gestacional. CONCLUSÕES: os efeitos cumulativos do tabagismo apontam para a necessidade de incentivar o abandono do hábito de fumar entre as gestantes, especialmente entre aquelas com baixo índice de massa corporal e em idade mais avançada, devido ao risco aumentado de prematuridade neste grupo específico.

Apesar de ser conhecido que recém-nascidos de baixo peso são capazes de vivenciar a dor, muitos procedimentos de rotina ainda são realizados sem o uso de analgésicos farmacológicos ou não farmacológicos. A posição canguru é uma estratégia de baixo custo e pode ser utilizado como medida de escolha no manejo da dor de recém-nascidos pré-termos. Torna-se importante encorajar a prática desse método pelas mães, uma vez que é fácil e pode ser realizado antes e durante procedimentos dolorosos invasivos em unidades neonatais contribuindo para a redução álgicaAlthough low-birth neonates are acknowledged to experience pain, many routine procedures continue to be conducted without proper pharmacological or non-pharmacological analgesia. Kangaroo care is a low-cost strategy that can be used in the preterm newborn. Mothers should be encouraged to use this easy-to-perform method, which is feasible both before and during neonatal units' invasive procedures, therefore contributing to pain reduction

O estudo verificou a relação entre ansiedade materna, características neonatais e indicadores de desenvolvimento de crianças nascidas pré-termo aos 12 meses de idade cronológica corrigida. Foram avaliadas 14 crianças com as Escalas Bayley-II e suas mães com o Inventário de Ansiedade Traço-Estado. Os itens relativos à resolução de problemas, permanência do objeto, intencionalidade, linguagem e motricidade correlacionaram-se significativamente com variáveis neonatais do bebê e ansiedade materna. A maior gravidade de risco clínico neonatal associou-se com pior desempenho em itens relativos à permanência do objeto, linguagem e motricidade ampla. O nível de ansiedade materna mais elevado associou-se com melhor desempenho dos bebês em tarefas cognitivas e pior em tarefas de motricidade ampla e permanência do objeto. Dessa forma a ansiedade materna mostrou ter efeito diferencial em áreas do desenvolvimento da criança, podendo atuar como fator de risco ao desenvolvimento motor amplo e como mecanismo de proteção ao desenvolvimento cognitivo.El estudio verificó la relación entre ansiedad materna, características neonatales e indicadores de desarrollo de niños nacidos pré termo a los 12 meses de edad cronológica corregida. Fueron evaluados 14 niños con las Escalas Bayley-II y sus madres con el Inventario de Ansiedad Trazo-Estado. Los ítenes relativos a la resolución de problemas, permanencia del objeto, intencionalidad, lenguaje y motricidad se correlacionaron significativamente con variables neonatales del bebé y ansiedad materna. La mayor gravedad de riesgo clínico neonatal se asoció con peor desempeño en ítenes relativos a la permanencia del objeto, lenguaje y motricidad amplia. El nivel de ansiedad materna más elevado se asoció con mejor desempeño de los bebés en tareas cognitivas y peor en tareas de motricidad amplia y permanencia del objeto. De esa forma la ansiedad materna mostró tener efecto diferencial en áreas del desarrollo del niño, pudiendo actuar como factor de riesgo al desarrollo motor amplio y como mecanismo de protección al desarrollo cognitivo.Current study analyzes the relation between mother’s anxiety, pre-term neonatal status and developmental outcome in 12-month-old (corrected age) infants. Fourteen preterm children with very low weight at birth were assessed by Bayley-II Scales and mothers were evaluated by State-Trait Anxiety Inventory. Resolution problems, permanence of objects, intentionality, language and motor factors were significantly correlated with the child’s neonatal variables and with mother’s anxiety. The severest neonatal clinical risk has been linked to the child’s lowest performance with regard to permanence of object, language and broad motor factors. Mother’s highest anxiety level was significantly correlated with better performance on cognitive tasks and worst performance with motor and permanence of objects tasks. Mother’s anxiety showed to have differential effects on the infant’s development in certain areas. It may be a risk factor for gross motor development and a protection mechanism for cognitive development.

OBJETIVO: avaliar mudanças nos estados de humor de mães de bebês pré-termo em função do tipo de contato com o seu filho: Método Mãe-Canguru (MMC) e visita ao filho na incubadora da Unidade de Terapia Intensiva Neonatal. MÉTODOS: foi aplicada a Escala Analógica de Humor em 60 mães divididas em 2 grupos: mães que participam do Método Mãe-Canguru (GC) e mães que acompanharam o bebê na incubadora (GI). Os grupos foram pareados em função da idade das mães, número de gestações e tipo de parto. As mães foram avaliadas antes e depois de uma das visitas ao filho na incubadora ou sessão de MMC. RESULTADOS: as mães do GC melhoraram o humor, relatando: sentirem-se mais calmas, fortes, com idéias claras, ágeis, dinâmicas, satisfeitas, tranqüilas, perspicazes, relaxadas, atentas, competentes, alegres e amistosas. As mães do GI não apresentaram melhora no estado de humor em nenhum item, mas pioraram no item "sentindo-se desajeitada". CONCLUSÕES: o Método Mãe-Canguru mostrou-se eficaz na melhora nos estados de humor de mães de bebês pré-termo, contribuindo assim para a minimização dos efeitos negativos da internação neonatal.OBJECTIVE: to assess changes in the subjective state of mood of mothers of pre-term babies, comparing different kinds of mother-infant interaction: the Kangaroo Mother Method (KMM) and those observed on a visit to a Neonatal Intensive Care Unit. METHODS: the Visual Analogue Mood Scale was used with 60 mothers divided into two groups: mothers included in the Kangaroo Program (KG) and mothers with a baby on an incubator (IG). The groups were matched for the mothers' age, number of pregnancies and kind of delivery. The mothers were evaluated before and after a visit to the baby on an incubator or a KMM session. RESULTS: it was found that KG mothers were in a better mood, reporting that they felt calmer, stronger, more clear-headed, more agile, dynamic, satisfied, at ease, perceptive, relaxed, considerate, competent, happy and friendly. The IG mothers showed no positive variation in mood state but a negative variation for feeling clumsy. CONCLUSIONS: the Kangaroo Mother Method was shown to be efficient in improving the mood state of mothers of pre-term babies, thereby helping to minimize the negative effects of neonatal hospitalization.

O presente estudo teve como objetivo analisar a produção científica do período de 1998 a 2004, relacionada à interação entre mães e crianças nascidas pré-termo e seu desenvolvimento nas fases pré-escolar e escolar. Como método, foi realizado um levantamento bibliográfico sistematizado de estudos empíricos indexados nas bases de dados MEDLINE, PsycINFO e LILACS, utilizando as seguintes palavras-chave: preterm (very low birth weight, prematurity, premature birth) AND mother child interaction (mother child dyads, mother child relationship, mother child relations, maternal mediation). Foram identificados 33 artigos, dos quais foram selecionados 26 e foram localizados 22. A maioria dos estudos avaliou a interação mãe-criança nos primeiros quatro anos de idade, bem como seu impacto no desenvolvimento posterior da criança. Os estudos identificaram diferenças na interação entre díades mãe-criança ex-prematura e a termo nas fases pré-escolar, escolar e adolescente. Comportamentos interativos maternos exerceram efeito moderador diferencial no desenvolvimento de crianças vulneráveis com antecedentes de risco biológico.El objetivo de este trabajo fue analizar la producción científica desde 1998 hasta 2004 sobre la interacción entre las madres y sus niños nacidos prematuramente y su desarrollo en las fases parvulario y escolar. Como método se hizo una revisión de la bibliografía sistemática sobre estudios empíricos puestos en un índice en las bases de datos MEDLINE, PsycINFO y LILACS, utilizando las palabras-clave: pre-término (peso de nacimiento muy bajo, precocidad, nacimiento prematuro) e interacción madre-niño (dualidad madre-niño, relaciones madre-niño, mediación maternal). Fueron identificados 33 artículos, de los cuales se seleccionaron 26 y localizaron 22. La mayoría de los estudios evaluó la interacción madre-niño en los primeros cuatro años de vida, así como su impacto en el desarrollo posterior del niño. Los estudios identificaron diferencias en la interacción entre dualidades madre-niño ex prematura y la termo en las fases parvulario, escolar y adolescencia. Las conductas interactivas maternales ejercieron un efecto moderador diferencial en el desarrollo de niños vulnerables con antecedentes de riesgo biológico.The aim of the present study was to analyse the scientific publications, from 1998 to 2004, about interaction between mothers and their pre-term born children and their development at pre-school and school age. A systematic bibliographical review about empirical studies indexed on MEDLINE, PsycINFO and LILACS data bases was done, using as key-words the terms: 'preterm' (very low birth weight, prematurity, premature birth) and 'mother-child interaction' (mother child dyads, mother child relationship, mother child relations, maternal mediation). Thirty-three articles were identified, 26 were selected and 22 were achieved. Most studies assessed mother-child interaction at the first four years of life, as well as its impact on children's developmental outcome. The studies identified differences in the interaction between mother-pre term born child dyads and mother- full term born child dyads at pre-school and school age and at adolescence. Maternal interactive behaviors exerted a differential moderator effect on the developmental outcome of vulnerable children who presented previous biologic risk factors.

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Introduction: Premature infants with low birth weight can have neurologicals deficits and changes in social and communicative development. Early mother-infant interactions are important to evaluate the process of risk, checked from changes in non-verbal communication. Objective: Check the relationship between risk factors, socioeconomic and social communicative development of preterms to each group in four stages of development. Methods: Eigtheen dyads participated with gestational age < 36 6/7 weeks and birth weight ≤ 2500 grams. The sessions took place at three, six, nine and twelve months. Results: Was found that only children in the MP group initiated triadic interactions at nine months (M = 0,16; DP = 0,40). The ability involving person at three months was positively associated with weight at birth (0,812; p < 0,05), the apgar 5 (0,861; p < 0,05). Conclusion: Risk and socioeconomic factors influence the social communicative development of preterms. [ABSTRACT FROM AUTHOR]

OBJETIVO: Verificar a concordância entre as informações constantes no Sistema de Informação sobre Nascidos Vivos (Sinasc) referentes a partos hospitalares e aquelas obtidas por inquérito seccional (padrão-ouro). MÉTODOS: Realizou-se inquérito por amostragem em 2.831 partos hospitalares ocorridos em dez maternidades do município de São Luís, MA, abrangendo cerca de 98% dos nascimentos hospitalares da cidade. O arquivo do Sinasc foi comparado com os dados do inquérito perinatal após a realização de linkage por programa de computador. Foram analisados: a cobertura estimada do Sinasc em relação aos nascimentos hospitalares verificados, o percentual de informação ignorada ou não preenchida e o grau de concordância entre as informações constantes no arquivo do Sinasc com o arquivo perinatal. Na medida da concordância, foram utilizados o indicador "kappa", no caso de variáveis qualitativas, e a correlação intraclasse, em se tratando de variáveis quantitativas. RESULTADOS: A cobertura estimada do Sinasc foi de 75,8% (IC95%; 73,3%-78,2%). Os campos do Sinasc que apresentaram boa confiabilidade foram: peso ao nascer, sexo, hospital de nascimento, tipo de parto e idade materna. As estimativas do baixo peso ao nascer foram semelhantes nas duas pesquisas e a concordância foi alta (kappa=0,94). Entretanto, a prematuridade foi mais alta no inquérito (11,2%) do que no Sinasc (1,7%), e a concordância foi baixa (kappa=0,09). CONCLUSÃO: A cobertura estimada do Sinasc foi baixa. A análise do arquivo do Sinasc mostrou que a cobertura estimada foi baixa; a taxa de baixo peso ao nascer parece ter boa validade e reprodutibilidade; e a taxa de prematuridade está subestimada.OBJECTIVE: To verify the concordance between data routinely collected by the Sinasc (Information System on Live Births) and data obtained by a cross-sectional survey (gold standard). METHODS: The survey was performed in a sample of 2,831 hospital deliveries in ten maternity hospitals of the municipality of São Luís, Brazil. The sample frame represented about 98% of hospital births. Sinasc's data was compared with the survey data using a computerized linkage program. Sinasc's hospital births coverage, percentage of missing or unrecorded data and consistency between Sinasc 's and the survey's data were analyzed. Concordance was measured using the kappa indicator for qualitative variables and the intraclass correlation coefficient for quantitative variables. RESULTS: The estimated Sinasc coverage was 75.8% (95% CI: 73.3%-78.2%). Five Sinasc's data fields showed good reliability: birth weight, newborn sex, hospital of birth, type of delivery and maternal age. Low birth weight rates estimated by the two data sources were similar and the concordance was high (kappa=0.94). However, preterm birth rates were higher in the survey (11.2%) than according to Sinasc 's data (1.7%) and the concordance was low (kappa=0.09). CONCLUSIONS: Estimated Sinasc coverage was low. Low birth weight rates from Sinasc's data seem to be valid and reliable. Preterm birth rates from Sinasc's data are underestimated.

Currently, despite scientific and technological advances, morbidity and mortality infant continues to have high numbers, and in some cases inevitable. Given the importance of the issue, prematurity stands out as a major challenge today. For this purpose the improvement based on studies, provision of adequate care and early intervention for mothers and preterm infants is needed. This work deals with is an update article about the topic of prematurity and its epidemiological, clinical, diagnostic and therapeutic. [ABSTRACT FROM AUTHOR]

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Objective: To compare the efficacy and safety of a new porcinederived pulmonary surfactant developed by Instituto Butantan with those of animal-derived surfactants commercially available in Brazil, regarding neonatal mortality and the major complications of prematurity in preterm newborns with birth weight up to 1500g and diagnosed with respiratory distress syndrome. Methods: Neonates diagnosed with respiratory distress syndrome were randomized to receive either Butantan surfactant (Butantan group) or one of the following surfactants: Survanta® or Curosurf®. Newborns receiving Survanta® or Curosurf® comprised the control group. The main outcome measures were mortality rates at 72 hours and at 28 days of life; the typical complications of prematurity as evaluated on the 28th day of life were defined as secundary outcomes. Results: No differences were observed between the Butantan (n=154) and control (n=173) groups in relation to birth weight, gestational age, sex, and prenatal use of corticosteroids, or in mortality rates both at 72 hours (14.19% versus 14.12%; p=0.98) and at 28 days (39.86% versus 33.33%; p=0.24) of life. Higher 1- and 5-minute Apgar scores were observed among control group newborns. No differences were observed as regards the secondary outcomes, except for greater need for supplemental oxygen and a higher incidence of interstitial pulmonary emphysema in the Butantan group. Conclusion: The mortality rates at 72 hours and 28 days of life and the incidence of major complications of prematurity were comparable to those found with the animal-derived surfactants commercially available in Brazil, showing the efficacy and safety of the new surfactant in the treatment of respiratory distress syndrome in newborns. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of prematurity and low birth weight on development indicators, such as visual motor coordination, visual perceptive and fine motor skills of children in early schooling, as well as their relations with rates of global developmental delay. Method: It is a comparative study of case-control type. The research included 18 children with a history of preterm birth (Study Group), matched with 18 children without the same history (Comparison Group). These children were evaluated by the Denver Developmental Screening Test II and the test of Visual Motor Integration - VMI. Results: Statistical tests revealed significant differences between the Study Group and the Comparison Group regarding the visual motor (p = 0,000) and fine motor (p = 0,007) variables, while significant difference in performance between the Low Birth Weight and Appropriate Birth Weight groups was observed in the visual motor (p = 0,000), visual perceptive (p = 0,016) and fine motor (p = 0,036) variables, demonstrating that weight is more influential than prematurity in visual perception performance. Significant differences were observed in all parts of the VMI instrument (p = 0.001, p = 0.000, p = 0.000) when compared to the Denver Suspect and Denver Normal groups; it is possible to observed that poor performance on screening tests for development can be a predictive factor for poor performance on tests of visual motor integration. Conclusions: Preterm children showed worse performance in the assessment instruments confirming that preterm birth represents a risk to development. Skills of greater complexity required during schooling for reading and writing can be influenced by the visual motor, visual perceptive and fine motor difficulties. [ABSTRACT FROM AUTHOR]

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This article aims to analyze the scientific literature on the development of children born preterm with very low birth weight assessed by the Denver-II test in the period from 2000 to 2009. A survey of empirical literature indexed in Medline, Lilacs and Scielo was carried out through the combination of the keywords: preterm, very low birth weight, risk factors, development, and Denver-II. Twenty six articles were identified and eight were selected following the inclusion criteria. Most studies evaluated preterm children between 5 and 24 months of age. The studies identified a significant association between neonatal and environmental variables and the performance on Denver-II Test. Children born preterm must be followedup at outpatient Units to prevent and detect risks in development. [ABSTRACT FROM AUTHOR]

Objectives: to investigate pre-gestational risk factors for spontaneous preterm birth and, the role of smoking and its cumulative effects on prematurity. Methods: a case-control study analyzed a data set of all births occurring in a tertiary maternity hospital between April 2002 and July 2004. Spontaneous preterm births of single and live newborns without malformations were selected as cases. Controls were all the term births of live and single newborns without malformations during the same period. Three Outcomes were studied: all preterm births (<37 weeks), less than 35 weeks and less than 32 weeks of gestational age. Logistic regression was used to obtain the independent effect of pre-gestational risk factors. Results: maternal age of less than 20 years, low schooling, low maternal pre-gestational body mass index and smoking showed significant, independent association with spontaneous preterm birth for the three outcomes. For all these risk factors, excepting maternal smoking, odds ratios increased with decreasing gestational age at birth and this trend was significant for low maternal age and low pre-gestational body mass index. Conclusions: the cumulative effects of smoking calls for the need to encourage smoking cessation among pregnant women, especially those who are underweight and in the older age groups, because of the increased risk of delivering premature babies. [ABSTRACT FROM AUTHOR]

This quasi-experimental quantitative study, with pre-test and post test and a homogeneous control group, evaluated the effects of massage on the weight of preterm neonates hospitalized in neonatal intermediate care units. The sample consisted of 32 clinically stable and healthy preterm neonates, hospitalized in Portuguese intermediate neonatal care units. The preterm neonates were randomly allocated to two groups - control and experimental - with each group having an equal number of 16; there were no statistically significant differences between the groups on several baseline variables and thus they formed equivalent groups. The experimental group had an average of 30,11 weeks of gestation and weighed 1,326Kg at birth, and spent 20,44 days hospitalized in the intermediate care unit. The control group had an average of 30,94 weeks of gestation, weighed 1,400Kg at birth and spent 17,81 days hospitalized in the intermediate care unit. During the study, both groups received the same pattern of neonatal care, except that the experimental group received the massage. The massage was that of Field, used in Touch Research Institute, and was administered over five consecutive days in three daily periods. To evaluate the effect of the massage on weight gain, the preterm neonates were weighed daily in the same conditions, and it was demonstrated that those who had been massaged had an average daily weight gain 45% superior to that of the control group. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effects of aquatic physical therapy on pain and on the cycle of sleep and wakefulness among stable hospitalized premature infants. Methods: This study was characterized as an uncontrolled clinical trial on a time series and included 12 clinically stable newborns of gestational age less than 36 weeks who were hospitalized in a neonatal intensive care unit (NICU). After selection, the newborns were placed in a liquid medium for aquatic physical therapy lasting 10 minutes. Movements to stimulate flexor posture and postural organization were performed. The sleep-wakefulness cycle was assessed using the adapted Brazelton (1973)* scale and pain was assessed by the occurrence of signs of pain according to the Neonatal Facial Coding System (NFCS) scale; and physiological parameters. Results: In relation to states of sleep and wakefulness, before the physical therapy, the newborns' behavior varied from fully awake with vigorous body movements to crying. After the physical therapy, the states of sleep ranged from light sleep with closed eyes to some body movement. These values presented statistically significant differences (p<0.001). The score on the pain assessment scale also decreased from 5.38±0.91 to 0.25±0.46, with p<0.001 after the intervention. The vital signs remained stable. Conclusions: It is suggested that aquatic physical therapy can be a simple and effective method for reducing pain and improving sleep quality among preterm infants in NICUs. Controlled studies with larger numbers of subjects are needed in order to generalize the results. [ABSTRACT FROM AUTHOR]

This article presents a research about the behavior development of 21 preterm babies (between 33 and 36 weeks of pregnancy), from 1 to 12 months old, at the Hospital of the University of São Paulo, in Brazil, using the Child Behavior Development Scale - CBDS. The results showed that the preterm infants had an important improvement in the behavior development rhythm after the 3rd month of age, reducing in a statistically significant way the behaviors with pathological signs, but maintaining risk factors in 23% of non-normalized behaviors at 12 months of age. This study provides elements that can help the follow-up of the behavior development process of these children and the early detection of delays or possible disorders in that process. [ABSTRACT FROM AUTHOR]

Copyright of RPDI - Revista Portuguesa de Doenças Infecciosas is the property of Sociedade Portuguesa de Doencas Infecciosas e Microbiologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to assess changes in the subjective State of mood of mothers of pre-term babies, comparing different kinds of mother-infant interaction: the Kangaroo Mother Method (KMM) and those observed on a visit to a Neonatal Intensive Care Unit. Methods: the Visual Analogue Mood Scale was used with 60 mothers divided into two groups: mothers included in the Kangaroo Program (KG) and mothers with a baby on an incubator (IG). The groups were matched for the mothers' age, number of pregnancies and kind of delivery. The mothers were evaluated before and after a visit to the baby on an incubator or a KMM session. Results: it was found that KG mothers were in a better mood, reporting that they felt calmer, stronger, more clear-headed, more agile, dynamic, satisfied, at ease, perceptive, relaxed, considerate, competent, happy and friendly. The IG mothers showed no positive variation in mood state but a negative variation for feeling clumsy. Conclusions: the Kangaroo Mother Method was shown to be efficient in improving the mood state of mothers of pre-term babies, thereby helping to minimize the negative effects of neonatal hospitalization. [ABSTRACT FROM AUTHOR]

The Intraventricular-periventricular hemorrhage characteristics (IPVH) at the neonatal period in premature newborn constitutes an important event to prevent sequels in short and long stated period. The aim this study was evaluate the incidence of intraventricular- periventricular hemorrhage (IPVH) in premature newborn and to correlate it with weight, in observational and transversal study in a neonatal intensive unit therapy, the Hospital do Servidor Publico Estadual in the city of Säo Paulo, the period of January of 1996 the December of 1997. It was included 70 of 102 newborn (weight < 2000g). The classification of Papille was used, it classifies IPVH in four degrees, as the extension of the same one. The ultrasound diagnostics were carried through in the fourth, eighth, fifteenth and twenty-eighth days of life, since that the newborn remained interned in the intensive unit. 32 cases of IPVH were diagnostic. It had statically significant correlation (pd”0,001) of the weight with occurrence of IPVH and the IPVH group showed lesser weight. However, the IPVH is a frequent event in preterm newborn and it was related with weight < 1500g. The ultrasonographic examination revealed efficiency at the diagnostic. Thus, when it is realized diagnosis of IPVH, we suggest taking the newborn to the multidisciplinar accompaniment. [ABSTRACT FROM AUTHOR]