Primary Health Care as a guide for assistance to infants at risk of neurodevelopmental disorders

• Published in: CoDAS (São Paulo) Vol. 30; no. 3; p. 302
• Main Authors: Molini-Avejonas, Daniela Regina, Rondon-Melo, Silmara, Batista, Estela Ramos, Souza, Amanda Calsolari de, Dias, Daniela Cardilli, Samelli, Alessandra Gianella
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 2018
• Subjects: Adolescent; Apgar Score; Brazil; Female; Gestational Age; Health Planning Guidelines; Humans; Neurodevelopmental Disorders - prevention & control; Primary Health Care - standards; Referral and Consultation; Risk Factors
• ISSN: 2317-1782
• DOI: 10.1590/2317-1782/20182017064

Purpose Characterize infants at risk of neurodevelopmental disorders according to sociodemographic and health profiles and describe their monitoring in Basic Health Units (UBS) under different management models. Methods Data were collected from medical records of infants at risk of neurodevelopmental disorders in the west region of the city of Sao Paulo from August 2013 to February 2014 (phase 1 - characterization; phase 2 - monitoring). Results Of the 225 individuals assessed in the first phase of the study, 51.1% were female and 7.11% were twins. Adolescent (45.2%), brown (50.56%), single (46.09%), complete primary education (47.60%) mothers were predominant. The mean number of prenatal visits was 7.12. Most mothers had vaginal delivery (62.22%) at mean gestational age of 37.05 weeks. Mean Apgar scores at the 1st and 5th minutes were 7.13 and 8.80, respectively. Mean weight at birth was 2597.21g., with 50.22% of newborns weighting ≤2500g. In its second phase, the study describes and compares the follow-up of 55 infants according to the UBS management model: 28 in UBS/"Estratégia Saúde da Família" (UBS/ESF) and 27 in traditional UBS (UBS/T). UBS/ESF presented higher mean of consultations (p=0.006). Longer interval between consultations was observed at UBS/T. No records of development milestones were found in 56% of the sample. Growth measures were better registered at UBS/ESF. In both management models, the number of consultations was smaller and the interval between them was shorter than those recommended by the Brazilian Ministry of Health. Conclusion According to the recommended guidelines of the "Rede Cegonha" public policy, gaps in the monitoring of infants at risk of neurodevelopmental disorders are still observed.