Bronchopulmonary dysplasia effects on motor development of preterm newborn infants

Analysis of bronchopulmonary dysplasia effects on motor development of preterm newborn infants


Maternal-Infant Institute

Research Journal of Pharmacology and Pharmacy-2d Code

In recent decades with scientific advances in neonatal care there was an increase in survival of newborn preterm (NPT) however associated with this there is an increase in the occurrence of morbidity, especially bronchopulmonary dysplasia (BPD)1. The bronchodysplasia children have deficits in motor development2,3 which can manifest as abnormal movements of limbs, neck and trunk, low response threshold in muscle tone, deficits in fine motor skills and gross, and impaired visual-spatial perception, a frequency twice as high as the NPT without BPD4,5. The use of instruments such as selective development testing promotes early intervention for growth and deviations from normal development in children and helps in diagnosis and prognosis4. The objective of this study was to evaluate and compare the motor performance of (NPT) with and without BPD. These were divided into two groups: group 1 (G1) consists of preterm infants without BPD (n = 19) and group 2 (G2) with BPD (n = 11). The sample was selected from preterm infants born in Integrative Medicine Institute Prof. Fernando Figueira (IMIP) with gestational age below 33 weeks and birth weight less than 1500g. Those with genetic syndromes, progressive diseases, central nervous system malformations were excluded. The Kolmogorov-Smirnov and Levene determined normality and homogeneity of the sample. Intra-group comparison was performed using the Student t test with Pearson’s correlation coefficient, while the intergroup comparison was performed by ANOVA. An inverse relationship between length of stay in neonatal ICU was observed (NICU), oxygen therapy and mechanical ventilation with TIMP score for both groups and was not observed significant difference between the scores achieved by G1 (55.37 ± 4.91) and the G2 (54.82 ± 7.9). Changes in the development of preterm infants with BPD have been increasingly described in the literature and establish a relationship, the greater the severity of BPD, the greater the risk of developing neurodevelopmental sequelae. Cognitive deficits, learning difficulties and behavioral problems could be due to delay maturacional6. Although there are studies that show the environmental impact in preterm, the influence of DBP in the neurodevelopment of infants of very low birth weight is a factor of controversy. Souza et al7 found no significant differences between carriers and noncarriers of BPD when evaluated from the Neurological Evaluation Dubowitz. Interestingly, in this same study, the author finds most normalcy in variable placement plant, raising the head in prone, abnormalities in posture and foot, fear and irritability in the group with DBP8. It is possible that particular stages of development in children with BPD may prove to be different from other preterm infants, especially of motor trajectory of term infants 9,10. The here described results of the study revealed no significant differences in motor performance of preterm infants with and without dysplasia evaluated IGC between 38s and 39s and 6d. The oxygen therapy time is one of the criteria used to diagnose and classify DBP11. Children who make use of this for a long time and therapy with high oxygen inspired fractions are susceptible to hypoxemia, the main cause of pulmonary hypertension and cor pulmonale1. Oxygen therapy negatively influences weight gain and brain development of children with BPD, which would explain the low yield of these children when accompanied in the long term, studies that explore their cognitive skills and acadêmicas1,12. In our study, children with BPD were subjected to oxygen support for longer than children without BPD, which could explain its somewhat lower yield in TIMP.Nas recent decades, technological advances and a better understanding of the pathophysiology of neonatal problems have reduced the mortality and incidence of neurological problems. Accompanying these advances, it has been considered the environmental impact of the intensive care unit neonatal13. These children with dysplasia often pass through the NICU sector that uses as a treatment of mechanical ventilation (MV). The precise and proper management of VPM are important weapons in support preterm infants. However, mechanical ventilation is not without adverse effects may cause pulmonar14 commitment. Gonzaga et al14 in 2007, found that the development of BPD is related to the use of VM for longer than seven days which is consistent with the results found in this study, which found that infants with dysplasia underwent more days of VPM and oxygen and remained longer in the NICU than infants who did not develop the disease. In this sample, there was no significant difference in the score of TIMP between the examined groups. However, the small number of infants studied was a limitation of the study and this tendency for abnormal findings in the motor performance of newborns preterm infants with BPD could be proven with a larger sample of patients. In the scientific context, this work was relevant to ratify the vulnerable preterm infants, whether with BPD and without BPD and suggests that monitoring is done for each and every baby in the short and long term, so that it develops its full potential.

Keywords: Premature newborn, bronchopulmonary dysplasia, motor develompment, TIMP

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