The delay rate at 6 months and the association with psychosocial and environmental factors.

Tella, PC. Neurodevelopment assessment in a birth cohort, the delay rate at 6 months and the association with psychosocial and environmental factors. [Dissertation]. São Paulo: Faculty of Medicine, University of São Paulo, in 2015.

This study is a subproject of Developmental Psychiatry Institute entitled "New Tools in Child Development Understanding: Gene-Environment Interaction and Connectivity Neuronal", funded by FAPESP and approved by CAPPESQ with protocol number 0054/09.

It aims to characterize the neurological development of children aged 6 to 8 months by the Bayley scale in a population-based sample. It is expected, therefore, to estimate the prevalence of delay and the identification of psychosocial and environmental risk factors. The first years are particularly important in the life cycle, when is the rapid growth and development of the brain, making it vulnerable to exposure to different biological and psychosocial risk factors. Biological factors generally are accompanied by psychosocial and environmental factors that increase its effect. These adverse conditions are a risk factor and threat to child development. The importance and the impact of delays in the development of the child’s future, the earlier identified the delay development, the risk could be smaller. The purpose of this thesis was to characterize the neurological development of children 6-9 months ago through the Bayley scale in a population-based sample, then estimate the prevalence of delay and identifying psychosocial and environmental risk factors. A longitudinal epidemiological study of birth cohort with three segments, the first interview with the pregnant woman, to collect socioeconomic data and the psychiatric diagnoses interview, the second meeting to check psychiatric diagnoses in the postpartum period, data of birth and infant feeding. At last, on six months, implementation the Bayley Scale of Development. Evaluated 368 infants, 15.4% children were classified as significant delay in at least one of the areas, among them 10.87% had delayed motor development, language delay total of 8.15% and 3.01 % of infants were delayed cognitive. In analysis, found that cognitive development was the factor with the largest association of maternal stress factors. Disorders, mood during pregnancy, psychotic disorder and anxiety disorder in the postpartum period, economic class, maternal education, teenage mother and smoking during pregnancy were associated with delayed development even after adjusting for confounding factors. It is concluded that, psychiatric disorders are predictors of delay in psychomotor development at 6 months of age. This study shows the importance of screening to identify possible developmental delays, for subsequent intervention programs to prevent or minimize future hazards and allow the child to develop to their full potential.

Keywords: development; risk factors; infants.

Patrícia Tella, M.D

patriciatella@gmail.com