Evolutional neurologic evaluation of seven year-old children born prematurely

Ohiweiler, Lygia; Alfano, Ligia; Rotta, Newra T.

doi:10.1590/S0004-282X1996000300002

Abstracts

A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.

prematurely born children; development; evolutional neurologic evaluation

Para estudar o desenvolvimento neuropsicomotor em amostra de prematuros aos 7 anos de idade, foram avaliadas 51 crianças prematuras e comparadas com 44 a termo. O grupo de prematuros tinha idade gestacional de até 37 semanas e 6 dias e peso de nascimento até 2500g. O grupo controle foi constituído de crianças com idade gestacional entre 38 e 42 semanas e acima de 2500g. Os instrumentos de avaliação utilizados foram os exames clinico, neurológico e neurológico evolutivo (ENE). Os resultados mostraram que impulsividade, agressividade, desorganização e enurese foram sintomas prevalentes nos prematuros. As alterações no exame neurológico não discriminaram os grupos, embora paralisia cerebral só tenha ocorrido nos prematuros. As funções do ENE que distinguiram os grupos foram equilíbrio dinâmico, coordenação tronco-membros e persistência motora, constituindo-se esta no comprometimento dominante nos prematuros e as alterações na coordenação tronco-membros em achado peculiar neste grupo.

prematuridade; desenvolvimento neuropsicomotor; exame neurológico evolutivo

Evolutional neurologic evaluation of seven year-old children born prematurely

Avaliação neurológica evolutiva aos sete anos de idade de crianças nascidas prematuras

Lygia Ohiweiler^I; Ligia Alfano^II; Newra T. Rotta^III

^IDepartment of Pediatrics, Hospital de Clinicas de Porto Alegre (HPCA), Universidade Federal do Rio Grande do Sul, School of Medicine, Brazil. M.D., Assistant

^IIDepartment of Pediatrics, Hospital de Clinicas de Porto Alegre (HPCA), Universidade Federal do Rio Grande do Sul, School of Medicine, Brazil. M.D., Pediatric Neurologist

^IIIDepartment of Pediatrics, Hospital de Clinicas de Porto Alegre (HPCA), Universidade Federal do Rio Grande do Sul, School of Medicine, Brazil. M.D., Professor

ABSTRACT

A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.

Key words: prematurely born children, development, evolutional neurologic evaluation.

RESUMO

Para estudar o desenvolvimento neuropsicomotor em amostra de prematuros aos 7 anos de idade, foram avaliadas 51 crianças prematuras e comparadas com 44 a termo. O grupo de prematuros tinha idade gestacional de até 37 semanas e 6 dias e peso de nascimento até 2500g. O grupo controle foi constituído de crianças com idade gestacional entre 38 e 42 semanas e acima de 2500g. Os instrumentos de avaliação utilizados foram os exames clinico, neurológico e neurológico evolutivo (ENE). Os resultados mostraram que impulsividade, agressividade, desorganização e enurese foram sintomas prevalentes nos prematuros. As alterações no exame neurológico não discriminaram os grupos, embora paralisia cerebral só tenha ocorrido nos prematuros. As funções do ENE que distinguiram os grupos foram equilíbrio dinâmico, coordenação tronco-membros e persistência motora, constituindo-se esta no comprometimento dominante nos prematuros e as alterações na coordenação tronco-membros em achado peculiar neste grupo.

Palavras-chave: prematuridade, desenvolvimento neuropsicomotor, exame neurológico evolutivo.

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Aceite: 15-março-1996.

Dra. Lygia Ohlweiler - Serviço de Neurologia, Hospital de Clinicas de Porto Alegre - Av. Ramiro Barcelos 2350 - 90035-007 Porto Alegre RS-Brasil.

1. Alberman E, Evans SJW. A epidemiologia da prematuridade: etiologia, frequência e prognóstico. Anais Nestlé 1992;44:5-24.
2. Alvarez-Silva CR. Avaliação neurológica evolutiva de filhos de gestantes com hipertensão arterial crônica. Tese de Mestrado, Faculdade de Medicina Ribeirão Preto da Universidade de São Paulo. Ribeirão Preto, 1985.
3. Amiel-Tíson C. Neurological avaluation of the maturity of newborn infants. Arch Dis Child 1968;43:89-93.
4. Battaglia F, Lubchenco L. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967;71:159.
5. Behrman R, Hirsch RP, Fria TJ, Shapiro SM, Holzman I, Painter MJ. Cause of hearing loss in the high risk premature infant. J Pediatr 1985;106:95-101.
6. Bergman I, Shiono P. Neonatal risk factors. In Fanaroff AA, Martin RJ. Neonatal-perinatal medicine (Diseases of the fetus and infant). Ed 5. St Louis: Mosby, 1992.
7. Cypel S. Avaliação neurológica e de alguns aspectos do comportamento em crianças de 6 a 7 anos com e sem dificuldades do aprendizado. Tese de Livre Docência, Faculdade de Medicina da Universidade de São Paulo. São Paulo, 1983.
8. Felliman AM, Bryan EM, Elliman AD, Walker J, Harvey DR. Coordination of low birthweight seven-years-olds. Acta Paediatr Scand 1991;80:316-322.
9. Escobedo MB. Follow-up of prematurely born infants. Clin Obstetr Gynecol 1988;31:662-667.
10. Fedrizzi E, Zuccarino ML, Vizziello P. Clinical problems in neurodevelopmental diagnosis: a 7-year neurological and psychological follow-up study of low risk preterm infants. Ital J Neurol Sci 1986;5:117-126.
11. Fenichel GM. Neonatal neurology (The neurological consultation). New York: Churchill Livinstone 1990:1-16.
12. Forslund M. Growth and motor performance in preterm children at 8 years of age. Acta Paediatr 1992;81:840-842.
13. Forslund M, Bjerre I. Follow-up of preterm children: II. Growth and development at four years of age. Early Hum Dev 1992;24:107-110.
14. Guardiola A. Uso da imipramina no distúrbio de hiperatividade com déficit de atenção. Tese de Mestrado, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, 1990.
15. Holmqvist P, Pleven H, Svenningsen NW. Vaginally born low-risk infants: fetal acidosis and outcome at 6 years of age. Acta Paediatr Scand 1988;77:638-641.
16. Klein NR, Hack M, Breslau N. Children who were very low birthweight: development and academic achievement at nine years of age. J Dev Behav Pediatr 1989;10:32-37.
17. Lefèvre AB. Exame neurológico evolutivo. São Paulo: Sarvier, 1972.
18. Lefèvre AB. Disfunção cerebral mínima: estudo multidisciplinar. São Paulo: Sarvier; 1975.
19. Lezine I. El desarollo psicomotor del nino. México: Grijalbo, 1971.
20. Lubchenco LO, Hansman C, Dressier M, Boyd E. Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation. Pediatrics 1963;32:793-800.
21. Michelsson K, Noronen M. Neurological psychological and articulatory impairment in five-year-old children with a birthweight of 2000g or less. Eur J Pediatr 1983;141:96-100.
22. Minkowski M. Neuropsicologia y pediatria (Acerca de la evolucion anátomo-fisiológica de las funciones cerebrates en el lactente parvulo). Buenos Aires: Alfa, 1956.
23. Nickel RE, Brennett FC, Lamson FN. School performance of children with birthweights of lOOOg or less. Am J Dis Child 1982;136:105-110.
24. Ounted MK, Moar VA, Scott A. Small for dates babies at the age of four years: health, handicap and developmental status. Early Hum Dev 1983;8:243-258.
25. Robertson CM, Etches PC, Kyle JM. Eight-year school performance and growth of preterm, small for gestational age infants: a comparative study with subjects matched for birth weight or for gestational age. J Pediatr 1990; 116:19-26.
26. Rotta NT. Avaliação neurológica evolutiva, eletrencefalográfica e psicológica em crianças com rendimento escolar deficiente. Tese de Livre Docência. Faculdade de Medicina da Universidade de São Paulo. São Paulo, 1975.
27. Saint-Anne Dargassies, S. Normality and normalization as seen in a long-term neurological follow-up of 286 truly premature infants. Neuropädiatrie 1979;10:226-242.
28. Saint-Anne Dargassies, S. As bases da neurologia do desenvolvimento do lactente. São Paulo: Manole: 1980:25-40.
29. Volpe JJ. Neurology of the newborn. Ed 3. Philadelphia: Saunders, 1995:43-92.

Publication Dates

Publication in this collection
10 Nov 2010
Date of issue
Sept 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Alberman E, Evans SJW. A epidemiologia da prematuridade: etiologia, frequência e prognóstico. Anais Nestlé 1992;44:5-24.

[2] 2. Alvarez-Silva CR. Avaliação neurológica evolutiva de filhos de gestantes com hipertensão arterial crônica. Tese de Mestrado, Faculdade de Medicina Ribeirão Preto da Universidade de São Paulo. Ribeirão Preto, 1985.

[3] 3. Amiel-Tíson C. Neurological avaluation of the maturity of newborn infants. Arch Dis Child 1968;43:89-93.

[4] 4. Battaglia F, Lubchenco L. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967;71:159.

[5] 5. Behrman R, Hirsch RP, Fria TJ, Shapiro SM, Holzman I, Painter MJ. Cause of hearing loss in the high risk premature infant. J Pediatr 1985;106:95-101.

[6] 6. Bergman I, Shiono P. Neonatal risk factors. In Fanaroff AA, Martin RJ. Neonatal-perinatal medicine (Diseases of the fetus and infant). Ed 5. St Louis: Mosby, 1992.

[7] 7. Cypel S. Avaliação neurológica e de alguns aspectos do comportamento em crianças de 6 a 7 anos com e sem dificuldades do aprendizado. Tese de Livre Docência, Faculdade de Medicina da Universidade de São Paulo. São Paulo, 1983.

[8] 8. Felliman AM, Bryan EM, Elliman AD, Walker J, Harvey DR. Coordination of low birthweight seven-years-olds. Acta Paediatr Scand 1991;80:316-322.

[9] 9. Escobedo MB. Follow-up of prematurely born infants. Clin Obstetr Gynecol 1988;31:662-667.

[10] 10. Fedrizzi E, Zuccarino ML, Vizziello P. Clinical problems in neurodevelopmental diagnosis: a 7-year neurological and psychological follow-up study of low risk preterm infants. Ital J Neurol Sci 1986;5:117-126.

[11] 11. Fenichel GM. Neonatal neurology (The neurological consultation). New York: Churchill Livinstone 1990:1-16.

[12] 12. Forslund M. Growth and motor performance in preterm children at 8 years of age. Acta Paediatr 1992;81:840-842.

[13] 13. Forslund M, Bjerre I. Follow-up of preterm children: II. Growth and development at four years of age. Early Hum Dev 1992;24:107-110.

[14] 14. Guardiola A. Uso da imipramina no distúrbio de hiperatividade com déficit de atenção. Tese de Mestrado, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, 1990.

[15] 15. Holmqvist P, Pleven H, Svenningsen NW. Vaginally born low-risk infants: fetal acidosis and outcome at 6 years of age. Acta Paediatr Scand 1988;77:638-641.

[16] 16. Klein NR, Hack M, Breslau N. Children who were very low birthweight: development and academic achievement at nine years of age. J Dev Behav Pediatr 1989;10:32-37.

[17] 17. Lefèvre AB. Exame neurológico evolutivo. São Paulo: Sarvier, 1972.

[18] 18. Lefèvre AB. Disfunção cerebral mínima: estudo multidisciplinar. São Paulo: Sarvier; 1975.

[19] 19. Lezine I. El desarollo psicomotor del nino. México: Grijalbo, 1971.

[20] 20. Lubchenco LO, Hansman C, Dressier M, Boyd E. Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation. Pediatrics 1963;32:793-800.

[21] 21. Michelsson K, Noronen M. Neurological psychological and articulatory impairment in five-year-old children with a birthweight of 2000g or less. Eur J Pediatr 1983;141:96-100.

[22] 22. Minkowski M. Neuropsicologia y pediatria (Acerca de la evolucion anátomo-fisiológica de las funciones cerebrates en el lactente parvulo). Buenos Aires: Alfa, 1956.

[23] 23. Nickel RE, Brennett FC, Lamson FN. School performance of children with birthweights of lOOOg or less. Am J Dis Child 1982;136:105-110.

[24] 24. Ounted MK, Moar VA, Scott A. Small for dates babies at the age of four years: health, handicap and developmental status. Early Hum Dev 1983;8:243-258.

[25] 25. Robertson CM, Etches PC, Kyle JM. Eight-year school performance and growth of preterm, small for gestational age infants: a comparative study with subjects matched for birth weight or for gestational age. J Pediatr 1990; 116:19-26.

[26] 26. Rotta NT. Avaliação neurológica evolutiva, eletrencefalográfica e psicológica em crianças com rendimento escolar deficiente. Tese de Livre Docência. Faculdade de Medicina da Universidade de São Paulo. São Paulo, 1975.

[27] 27. Saint-Anne Dargassies, S. Normality and normalization as seen in a long-term neurological follow-up of 286 truly premature infants. Neuropädiatrie 1979;10:226-242.

[28] 28. Saint-Anne Dargassies, S. As bases da neurologia do desenvolvimento do lactente. São Paulo: Manole: 1980:25-40.

[29] 29. Volpe JJ. Neurology of the newborn. Ed 3. Philadelphia: Saunders, 1995:43-92.