Neurodesenvolvimento em pré-termos nascidos com Idade gestacional inferior a 33 semanas avaliados pela Escala bayley 3 [terceira] edição

The purpose of the study is to describe the neurodevelopment of children born preterm with gestational age less than 33 weeks during the first two years corrected age, assessed between 18 and 24 months corrected age, with the Bayley Scale III. Cross-sectional study carried out between December 2010 and July 2011 in a cohort of children born preterm and followed up in the Follow Up Clinic of the Department of Neonatology of the Instituto Fernandes Figueira. This cohort was started in 2005 with the objective of assessing the development and growth of premature infants with gestational age less than 33 weeks. Information on history of pregnancy, birth, anthropometric data of the newborn, neonatal history, nutrition, socio-economic and family outcomes after discharge from the neonatal unit and the results obtained in the Bayley Scale III were recorded. 104 children were evaluated, with 45.2% male and 21.2% small for gestational age newborns, and the mean gestational age was 29 weeks and 5 days. The average language score (81.9) was below -1 SD differently from the average cognitive (93.7) and motor (91.1), which were within ± 1 SD. Abnormalities in language development occurred in 50% of children, motor disorders in 25% and cognitive impairment in 13% . There was greater impairment in receptive language (3.3 points below the standard). There was no difference in motor, language and cognitive development between SGA and AGA children. Male sex was risk for abnormal language and motor development, and pneumonia was a risk factor for low scores in language. The prevalence ratio for cognitive score below 85, in relation to perinatal and socioeconomic factors, showed risk for pneumonia (3.4 RP - CI 1.23 to 9.3) and APGAR less than 6 at the fifth minute (PR 3 , 6 - CI 1.07 to 12). In relation to language score below 85, the risk factors were male sex (PR 1.5 - CI 1.03 to 2.25), APGAR score less than 6 at the fifth minute (RP 1.65 - IC 1.01 to 2.7) and pneumonia (RP 2.05 - CI 1.54 to 2.73), and living with parents was a protective factor (RP 0.48 - CI 0.23 to 0.98). Considering the motor, score only male sex (PR 2.15 - CI 1.04 to 4.42) showed risk for abnormality. No factors were significant for abnormal cognitive score. There was no influence of maternal and paternal education, the presence of the mother and the income (per capita) in the average results of scores. The absence of a father figure showed risk for motor score less than 85 (PR 2.96 - CI 1.55 to 5.6). In the multivariate analysis, no factor was significant for abnormal cognitive score. In relation to language score, only male sex and pneumonia showed risk for abnormal development, and structured family was a protective factor in relation to language. The risk for abnormal motor score was significant only among males. In the assessment of development in preterm infants below 33 weeks gestational age using the Bayley Scale III, language development was altered with a score below the average, with mild delay in 50% of infants, but the mean cognitive and motor scores were normal. The development of AGA and SGA children was similar in the three areas studied and the male sex was a risk factor for both motor and language abnormality. The raw receptive language score was lower than expected for age with no abnormality in expressive language.