RESUMO
Objetivo: conhecer a experiência dos pais na aplicação do Método Canguru no domicílio. Método: pesquisa qualitativa cujos dados foram obtidos entre março e dezembro de 2016, por meio de entrevistas com 12 mães e três pais de recém-nascidos pré-termos e/ou baixo peso, participantes da terceira etapa do Método Canguru, que foram submetidas à técnica de análise de conteúdo temática. Resultados: os pais mantiveram a posição canguru no domicílio. Apesar de cada família desenvolvê-la de forma diferente, não deixaram de realizá-la. Também conseguiram adaptar-se à nova rotina de cuidados com a chegada do filho em casa e relataram satisfação com as consultas da terceira etapa e de seguimento realizadas no hospital. Conclusão: os pais, mesmo diante dos desafios diários com os cuidados no domicílio, detêm uma significação clara sobre a importância da Posição Canguru para os recém-nascidos pré-termos e/ou baixo peso e sua capacidade de impactar na qualidade do cuidado oferecido.
Objective: to get to know the parents' experience in applying the Kangaroo Mother Care at home. Method: qualitative research with data obtained between March and December 2016, by means of interviews with 12 mothers and three fathers of preterm and/or low-birth-weight newborns, participants in the third stage of the Kangaroo Method. The interviews were submitted to thematic content analysis technique. Results: the parents maintained the kangaroo position at home. Although each family developed it differently, they have not failed to implement it. They were also able to adapt to the new care routine with the arrival of the child at home and reported satisfaction with the medical appointments of the third stage and the follow-up carried out at the hospital. Conclusion: the parents, despite the daily challenges with home care, have a clear meaning about the importance of the Kangaroo Position for preterm and / or low-birth-weight newborns and its ability to affect the quality of care offered.
Objetivo: conocer la experiencia de los padres durante la puesta en práctica del Método Canguro en el domicilio. Método: investigación cualitativa cuyos datos se obtuvieron entre marzo y diciembre de 2016, por medio de entrevistas con 12 madres y tres padres de recién nacidos pretérminos y/o bajo peso, participantes de la tercera etapa del Método Canguro, que se sometieron a la técnica de análisis de contenido temático. Resultados: los padres mantuvieron la posición canguro en el domicilio. Aunque cada familia la haya desarrollado de forma diferente, no dejaron de realizarla. También lograron adaptarse a la nueva rutina de cuidados con la llegada del hijo a casa y relataron satisfacción con las consultas de la tercera etapa y de seguimiento realizadas en el hospital. Conclusión: los padres, aunque estén ante los desafíos diarios con los cuidados en el domicilio, detienen una preocupación clara sobre la importancia de la Posición Canguro para los recién nacidos pretérminos y/o bajo peso y su capacidad de afectar la calidad del cuidado ofrecido.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Relações Pais-Filho , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Método Canguru/psicologiaRESUMO
Abstract: Objective: Visual preference for faces at birth is the product of a multimodal sensory experience experienced by the fetus even during the gestational period. The ability to recognize faces allows an ecologically advantageous interaction with the social environment. However, perinatal events such as premature birth, may adversely affect the adequate development of this capacity. In this study, we evaluated the preference for facial stimuli in preterm infants within the first few hours after birth. Methods: This is a cross-sectional observational study of 59 newborns, 28 preterm and 31 full-term infants. The babies were assessed in the first hours of life, with two white boards in the shape of a head and neck: one with the drawing of a face similar to the human face (natural face), and one with the drawing of misaligned eyes, mouth and nose (distorted face). After the newborn fixated the eyes on the presented stimulus, it was slowly moved along the visual field. The recognition of the stimulus was considered present when the baby had eye or head movements toward the stimulus. Results: The preterm infants, in addition to showing a lower occurrence of orientation movements for both stimuli, on average (1.8 ± 1.1 to natural faces and 2.0 ± 1.2 for distorted ones) also showed no preference for any of them (p = 0.35). Full-term newborns showed a different behavior, in which they showed a preference for natural faces (p = 0.002) and a higher number of orientations for the stimulus, for both natural (3.2 ± 0.8) and distorted faces (2.5 ± 0.9). Conclusion: Preterm newborns recognize facial stimuli and disclose no preference for natural faces, different from full-term newborns.
Resumo: Objetivo: A preferência visual por faces ao nascimento é produto de uma experiência sensorial multimodal vivenciada pelo feto ainda no período gestacional. A habilidade de reconhecer faces possibilita uma interação ecologicamente vantajosa com o ambiente social. Entretanto, eventos perinatais, como o nascimento prematuro, podem prejudicar o desenvolvimento adequado dessa habilidade. Neste trabalho, avaliamos a preferência por estímulos faciais de recém-nascidos prematuros nas primeiras horas após o nascimento. Métodos: Trata-se de um estudo observacional transversal feito com 59 recém-nascidos, 28 prematuros e 31 nascidos termos. Os bebês foram avaliados, nas primeiras horas de vida, com duas pranchas brancas em formato de cabeça e pescoço: uma com o desenho de uma face similar ao rosto humano (face natural) e outra com o desenho de olhos, boca e nariz desalinhados (face distorcida). Após o recém-nascido fixar o olhar no estímulo apresentado, era lentamente movimentado ao longo do campo visual. O reconhecimento do estímulo foi considerado presente quando o bebê apresentou movimentos dos olhos ou cabeça em direção ao estímulo. Resultados: Os recém-nascidos prematuros, além de apresentar menor ocorrência de movimentos de orientação para ambos os estímulos, em média (1,8 ± 1,1 para faces naturais e 2 ± 1,2 para faces distorcidas), também não apresentaram preferência por qualquer um deles (p = 0,35). Diferente foi o comportamento dos recém-nascidos a termo, que apresentaram preferência por faces naturais (p = 0,002) e um número maior de orientações para o estímulo, tanto para faces naturais (3,2 ± 0,8) quanto para faces distorcidas (2,5 ± 0,9). Conclusão: Recém-nascidos prematuros reconhecem os estímulos faciais e não apresentam preferência por faces naturais, diferentemente de recém-nascidos a termos.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Reconhecimento Facial , Recém-Nascido Prematuro , Desenvolvimento Infantil , Comportamento de Escolha , Estudos Transversais , Idade Gestacional , Fixação OcularRESUMO
OBJECTIVE: Visual preference for faces at birth is the product of a multimodal sensory experience experienced by the fetus even during the gestational period. The ability to recognize faces allows an ecologically advantageous interaction with the social environment. However, perinatal events such as premature birth, may adversely affect the adequate development of this capacity. In this study, we evaluated the preference for facial stimuli in preterm infants within the first few hours after birth. METHODS: This is a cross-sectional observational study of 59 newborns, 28 preterm and 31 full-term infants. The babies were assessed in the first hours of life, with two white boards in the shape of a head and neck: one with the drawing of a face similar to the human face (natural face), and one with the drawing of misaligned eyes, mouth and nose (distorted face). After the newborn fixated the eyes on the presented stimulus, it was slowly moved along the visual field. The recognition of the stimulus was considered present when the baby had eye or head movements toward the stimulus. RESULTS: The preterm infants, in addition to showing a lower occurrence of orientation movements for both stimuli, on average (1.8±1.1 to natural faces and 2.0±1.2 for distorted ones) also showed no preference for any of them (p=0.35). Full-term newborns showed a different behavior, in which they showed a preference for natural faces (p=0.002) and a higher number of orientations for the stimulus, for both natural (3.2±0.8) and distorted faces (2.5±0.9). CONCLUSION: Preterm newborns recognize facial stimuli and disclose no preference for natural faces, different from full-term newborns.
Assuntos
Reconhecimento Facial , Desenvolvimento Infantil , Comportamento de Escolha , Estudos Transversais , Feminino , Fixação Ocular , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , MasculinoRESUMO
OBJECTIVE: To investigate risk factors for neonatal arterial ischemic stroke (NAIS), and compare them with those present in term controls and infants with hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: Antepartum and intrapartum data were collected at presentation from 79 infants with NAIS and compared with 239 controls and 405 infants with HIE. The relationships between risk factors and NAIS were explored using univariable and multivariable regression. RESULTS: Compared with controls, infants with NAIS more frequently had a family history of seizures/neurologic diseases, primiparous mothers, and male sex. Mothers of infants with NAIS experienced more intrapartum complications: prolonged rupture of membranes (21% vs 2%), fever (14% vs 3%), thick meconium (25% vs 7%), prolonged second stage (31% vs 13%), tight nuchal cord (15% vs 6%), and abnorm8al cardiotocography (67% vs 21%). Male sex (OR 2.8), family history of seizures (OR 6.5) or neurologic diseases (OR 4.9), and ≥1 (OR 5.8) and ≥2 (OR 21.8) intrapartum complications were independently associated with NAIS. Infants with NAIS and HIE experienced similar rates though different patterns of intrapartum complications. Maternal fever, prolonged rupture of membranes, prolonged second stage, tight nuchal cord, and failed ventouse delivery were more common in NAIS; thick meconium, sentinel events, and shoulder dystocia were more frequent in HIE. Abnormal cardiotocography occurred in 67% of NAIS and 77.5% of infants with HIE. One infant with NAIS and no infant with HIE was delivered by elective cesarean (10% of controls). CONCLUSIONS: NAIS is multifactorial in origin and shares risk factors in common with HIE. Intrapartum events may play a more significant role in the pathogenesis of NAIS than previously recognized.
Assuntos
Infarto da Artéria Cerebral Média/epidemiologia , Complicações na Gravidez/epidemiologia , Cardiotocografia , Estudos de Casos e Controles , Distocia/epidemiologia , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Febre/epidemiologia , Predisposição Genética para Doença , Humanos , Hipóxia-Isquemia Encefálica/epidemiologia , Recém-Nascido , Segunda Fase do Trabalho de Parto , Estudos Longitudinais , Masculino , Mecônio , Cordão Nucal/complicações , Gravidez , Estudos Retrospectivos , Fatores de Risco , Convulsões/complicações , Fatores SexuaisRESUMO
Los accidentes vasculares hemorrágicos cerebrales en el recién nacido a término constituyen un aspecto importante de la morbimortalidad en la etapa neonatal. Se presenta el caso de un recién nacido a término, normopeso, varón, nacido de parto distócico en presentación pelviana (distocia de cabeza última), con una asfixia severa al nacer, que requirió de medidas de reanimación y de asistencia ventilatoria mecánica, constatando las manifestaciones clínicas de un accidente vascular hemorrágico, que se corroboró con los estudios imagenológicos realizados. Es egresado al mes de edad, sin compromiso de sus funciones vitales, y seguido por una consulta multidisciplinaria. A los tres meses de edad muestra evidencias de secuelas determinadas por retraso en su desarrollo psico-motor y trastornos neurosensoriales. La rehabilitación se está realizando con el objetivo de mejorar su actividad motora y su proyección psicosocial.
Cerebrovascular haemorrhagic accidents in term infant constitute an important feature of mortality in neonatal stage. A case of a male normoweight term infant who was born from a dystocic delivery in pelvis presentation (late-head dystocia) with a severe asphyxia at birth was analyzed. The infant required resuscitation techniques and mechanical ventilation, noting the clinical manifestations of haemorrhagic vascular accident, which could be proved through imaging studies carried out. At the age of one month the patient was discharged from the hospital with no compromise of vital functions and multidisciplinary follow-up. At the age of 3 months he showed specific sequels of retardation in psychomotor development and neurosensory disorders. Rehabilitation is been carried out with the objective of improving motor activity and psychosocial projection.