Evaluation the motor developmental and the generalized movements of low birth weight preterm infants submitted to the Kangaroo Method
Infant Development, Premature Newborn, Kangaroo Method.
Introduction: The Kangaroo Method, implemented by many developing countries, is a strategy for improving neonatal care. This method seeks an organization of the immature physiological systems of the low weight premature, through the insertion of the parents into the care to the baby and the kangaroo position. Despite the already existing benefits of its development, little is known about the motor patterns and the movements generated by the premature infants undergoing this method. Aim: To evaluate the motor patterns and the generalized movements of low birth weight preterm infants submitted to the Kangaroo Method. Methodology: This is a cross-sectional study, carried out at the Januário Cicco Maternity School. The study included newborns with gestational age of less than 37 weeks, weighing less than 2500g, who were submitted to the Kangaroo Method (KM) in the first week of life. Clinical information about the baby and the mother's gestation was collected during hospitalization; the time of kangaroo position, during the second stage of the KM. In the first consultation of the third stage of the KM, the evaluation of the generalized movements and the Test Infant Motor Performance (TIMP) were applied. For statistical analysis, the significance level of 5% and 95% confidence interval were assigned for all analyzes. The descriptive analysis was presented in mean and standard deviation (SD). The normality of the study variables was verified using Shapiro Wilk test. Mann-Whitney was used to compare the means between the groups and the chi-square test was used for the categorical variables. Results: The sample consisted of 30 babies, to evaluate the generalized movements and 27 to evaluate the motor development. Of the studied population, 50% (15) presented altered spontaneous movement and 22.22% (6) presented atypical motor pattern. When comparing the means between the groups of the babies with normal and altered generalized movements, there was no significant difference between the samples regarding clinical variables and time of kangaroo position. Among the babies with typical motor pattern and atypical, there was a significant difference between the number of previous pregnancies (p = 0.04), the maximum total bilirubin level (p = 0.03) and the presence of grade I intraventricular hemorrhage (p = 0.05). Conclusion: Despite the strategies offered by the Kangaroo Method, the rate of babies with generalized motor and atypical motor patterns is still high, demonstrating the importance of this type of evaluation in the follow-up of low-weight preterm infants. In addition, it was observed that the number of pregnancies and the level of bilirubin negatively influenced the motor pattern of the babies and that the presence of grade I intraventricular hemorrhage might not influence the atypical motor pattern. Therefore, it is necessary to study the generalized movements and the motor pattern of the premature babies submitted to the Kangaroo Method to evaluate the causes of these changes and the effect of this method on these outcomes.