Neurodevelopment Of Small-for-gestational Age Infants: Behavioral Aspects In First Year.

The purpose of this study was to compare the behavior of full-term small-for-gestational age (SGA) with full-term appropriate-for gestational age (AGA) infants in the first year of life. We prospectively evaluated 68 infants in the 2nd month, 67 in the 6th month and 69 in the 12th month. The Bayley Scales of Infant Development-II were used, with emphasis on the Behavior Rating Scale (BRS). The groups were similar concerning the item interest in test materials and stimuli; there was a trend toward differences in the items negative affect, hypersensitivity to test materials and adaptation to change in test materials. The mean of Raw Score was significantly lower for the SGA group in the items predominant state, liability of state of arousal, positive affect, soothability when upset, energy, exploration of objects and surroundings, orientation toward examiner. A lower BRS score was associated with the SGA group in the 2nd month.72517-2

Behavior of full term small-for-gestational-age infants in the first year of life

Orientador: Vanda Maria Gimenes GonçalvesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: O objetivo deste estudo foi comparar o comportamento de lactentes nascidos a termo, pequenos para a idade gestacional (PIG) e lactentes nascidos com peso adequado para a idade gestacional (AIG), no primeiro ano de vida. Foram selecionados 125 neonatos na maternidade do Centro de Atenção Integral à Saúde da Mulher (CAISM/UNICAMP), obedecendo aos critérios de inclusão: pais ou responsáveis legais assinaram o Termo de Consentimento Livre e Esclarecido; neonatos que não necessitaram de cuidados especiais; com idade gestacional entre 37 e 41 semanas; com avaliação no 1º, 2º,3º,6º,9º,12º meses. A casuística foi composta por 95 lactentes que compareceram para pelo menos uma avaliação programada no 1º ano de vida, foi dividida em dois grupos de acordo com a adequação peso/idade gestacional; grupo PIG, constituído por 33 lactentes com peso ao nascer abaixo do percentil 10 e grupo AIG por 62 lactentes com peso entre o percentil 10 e 90 da curva de crescimento fetal de Battaglia e Lubchenco (1967). Para a avaliação do neurodesenvolvimento foram utilizadas as Escalas Bayley de Desenvolvimento Infantil II (BISID-II). Para a avaliação do comportamento do lactente, elegeu-se as Escalas de Classificação do Comportamento (ECC), das BSID-II. O estudo seccional avaliou no 1º mês: 63 lactentes (18PIG/45AIG). No 2º mês: 68 lactentes (25PIG/43AIG). No 3º mês: 68 lactentes (22PIG/46AIG). No 6º mês: 67 lactentes (25PIG/42AIG). No 9º mês: 61 lactentes (22PIG/39AIG) e no 12º mês: 68 lactentes (21PIG/47AIG). Os grupos foram semelhantes quanto às variáveis neonatais, exceto peso ao nascer. O peso foi significativamente menor no grupo PIG (p<0,001). Os grupos não apresentaram diferenças estatisticamente significativa na performance das Escalas Mental e Motora. Considerando o Index Score (IS) da Escala Mental, os resultados não demonstraram diferença estatisticamente significativa entre os grupos. Os resultados de IS da Escala Motora demonstraram diferença estatisticamente significativa entre os grupos, no 2º mês (p=0.008) e 12º mês (p=0.047). O grupo PIG apresentou valores medianos inferiores nestes meses. Considerando os resultados da performance comportamental na ECC, observou-se valores de significância estatística no 2º mês (pvalor=0.048), com maior freqüência relativa de lactentes PIG classificados como inadequados. Entre os fatores considerados na ECC nos primeiros meses de vida, apresentou valor de significância estatística o Fator Atenção/Vigília no 2º mês (p=0.005). Considerando a comparação dos resultados do percentil da ECC, os grupos demonstraram diferença estatisticamente significativa no 2º mês (p=0.001) e 3º mês (p=0.003). Os valores medianos foram inferiores no grupo PIG. No Fator Atenção/Vigília, os grupos de lactentes apresentaram diferença estatisticamente significativa no 2º mês (p=0.001) e 3º mês (p=0.003), sendo que os valores medianos foram inferiores no grupo PIG. No Fator Qualidade Motora os grupos apresentaram diferença estatisticamente significativa no 2º mês (p=0.045), sendo que os valores medianos foram inferiores no grupo PIGAbstract: The objective of this study was to compare the behavior of full-term small-for-gestational age (SGA) with full-term appropriate-for gestational age (AGA) infants in the first year of life. A hundred twenty five full-term neonates were selected at Neonatology Service in the Center of Integral Attention to Woman¿s Health (CAISM) of the State University of Campinas (UNICAMP), São Paulo, Brazil observing the inclusion criteria as follow: parents or legal guardians who signed the Informed Consent; neonates who did not need special care; gestational age between 37 and 41 weeks. They were assessed in the 1st , 2nd ,3rd ,6th ,9th and 12th months of life. Ninety five infants who came at least to one assessment during the first year of life were the sample. This sample was divided into two groups, according to weight and gestational age. In the SGA group there were 33 infants with birth weight less than percentile 10th and, in the AGA group, there were 62 infants whose birth weight varies between the 10th and 90th percentile on fetal growing Battaglia and Lubchenco method (1967). The Bayley Scales of Infant Development-II (BSID-II) (BAYLEY, 1993) were used with emphasis on the Behavior Rating Scale (BRS). The cross-sectional study evaluated in the 1st month, 63 infants (18 SGA and 45 AGA); in the 2nd month, 68 infants (25 SGA and 43 AGA); in the 3rd month, 68 infants (22 SGA and 46 AGA); in the 6th month, 67 infants (25 SGA and 42 AGA); in the 9th month, 61 infants (22 SGA and 39 AGA); in the 12th month, 68 infants (21 SGA and 47 AGA). The groups showed similar distribution in biologic variables on birth, except birth weight. The SGA group showed lower birth weight than AGA, with significant difference between them (p<0.001). No differences were observed in Mental and Motor Scales performance. No differences were observed in the IS of the Mental Scale. The Motor Scale median comparison showed lower IS in the SGA with significant difference in the 2th month (p=0.008) and in the 12th month (p=0.047). Considering in the BRS, it was observed that the inadequate performance was associated in the 2nd month (p=0.048) to a bigger number of SGA infants, classified as inadequate. As the results of performance of BRS factors are concerned, the Attention/Arousal Factor displayed significantly lower average values (p=0.005) in SGA group. The percentile results in BRS showed significant difference in the 2nd (p=0.001) e 3rd (p=0.003) months, with lower medium values in the SGA group. The Motor Factor displayed significantly lower average values in the SGA group in the 2nd month (p=0.045) with medium values lower in the SGA grouDoutoradoCiencias BiomedicasDoutor em Ciências Médica

Behavior of full term infants small for gestational age in the first three months of life

The objective was to compare the behavior of full-term infants small-for-gestational age (SGA) with full-term appropriate-for-gestational age (AGA). The sample considered 20 infants in the 1st, 2nd and in the 3rd months of life. The Bayley Scales of Infant Development-II were used, with attention to items related to Behavior Rate Scale (BRS). It was found that SGA infants showed lower average values in the BRS in the 2nd month. The Motor Quality Factor displayed significantly lower average values in SGA group, in the items Gross-motor Movement Required by Tasks, Control of Movements and Hypertonicity. The Attention/Arousal Factor in the items Exploration of Objects/Surroundings and Orientation to Examiner displayed significantly lower average values in the SGA group.O objetivo foi comparar o comportamento de lactentes nascidos a termo com peso adequado (AIG) a lactantes pequenos para a idade gestacional (PIG), no primeiro trimestre de vida. A amostra foi de 20 lactentes, avaliados no 1º, 2º e 3º meses. Foram utilizadas as Escalas Bayley de Desenvolvimento Infantil - II, com ênfase na Escala de Classificação do Comportamento (ECC). Houve diferença significativa entre os grupos no 2º mês, com maior número de lactentes PIG classificados como alterados na ECC. O Fator Qualidade Motora demonstrou valores da mediana significativamente menores no grupo PIG, nos itens Motricidade Axial, Controle de Movimentos e Hipertonia Muscular. O Fator Atenção/Vigília não mostrou diferença entre os grupos. Entretanto, quando analisados os itens Exploração de Objetos e de Ambiente e Interação com o Examinador, houve diferença significativa no 2º mês, com valores da mediana menores no grupo PIG.1046105

[behavior Of Full Term Infants Small For Gestational Age In The First Three Months Of Life].

The objective was to compare the behavior of full-term infants small-for-gestational age (SGA) with full-term appropriate-for-gestational age (AGA). The sample considered 20 infants in the 1st, 2nd and in the 3rd months of life. The Bayley Scales of Infant Development-II were used, with attention to items related to Behavior Rate Scale (BRS). It was found that SGA infants showed lower average values in the BRS in the 2nd month. The Motor Quality Factor displayed significantly lower average values in SGA group, in the items Gross-motor Movement Required by Tasks, Control of Movements and Hypertonicity. The Attention/Arousal Factor in the items Exploration of Objects/Surroundings and Orientation to Examiner displayed significantly lower average values in the SGA group.621046-5

Diphyllobothriasis, Brazil

Cases of human diphyllobothriasis have been reported worldwide. Only 1 case in Brazil was diagnosed by our institution from January 1998 to December 2003. By comparison, 18 cases were diagnosed from March 2004 to January 2005. All patients who became infected ate raw fish in sushi or sashimi

Agreement between scales for screening and diagnosis of motor development at 6 months

OBJECTIVE: To ascertain the degree of agreement between a score for screening and another for diagnosis of motor development in 6-month old infants and to define the most appropriate cutoff point for screening. METHODS: A sectional study, enrolling asymptomatic full term newborns with gestational ages from 37 to 41 weeks, who were discharged from the maternity unit 2 days after birth and are resident in the Campinas area. Infants were excluded if they presented genetic syndromes, malformations, congenital infections, intensive care admission or low birth weight. The assessment instruments investigated were the Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development II (BSID-II). Two cutoff points were evaluated for the AIMS, the 5th and 10th percentiles, and for the BSID-II infants were classified according to its motor index score (IS) as having inadequate (IS 85, above the mean minus 1 standard deviation). RESULTS: The study sample comprised 43 infants. Six infants (14.00%) exhibited inadequate motor performance. Using the BSID-II motor classification and the 5th percentile AIMS cutoff, sensitivity was 100%, specificity 78.37%, accuracy 81.39%, kappa index 0.50 and p 85, maior ou igual a menos 1 desvio padrão da média). RESULTADOS: A amostra foi constituída por 43 lactentes. Seis lactentes (14,00%) apresentaram desempenho motor inadequado. Considerando a classificação motora das BSID-II e o percentil 5 da AIMS, obteve-se sensibilidade = 100%, especificidade = 78,37%, acurácia = 81,39%, índice kappa = 0,50 e p < 0,001; considerando a classificação motora das BSID-II e o percentil 10 da AIMS, obteve-se sensibilidade = 100%, especificidade = 48,64%, acurácia = 55,81%, índice kappa = 0,20 e p = 0,025. CONCLUSÕES: Os resultados sugerem boa concordância entre os instrumentos de avaliação no sexto mês. A melhor combinação para os parâmetros analisados é a utilização do percentil 5 da AIMS.47047