Assessment of child development in premature babies based on the ICF biopsychosocial model

Eur J Phys Rehabil Med. 2021 Aug;57(4):585-592. doi: 10.23736/S1973-9087.20.06543-0. Epub 2020 Sep 25.

Abstract

Background: The International Classification of Functionality (ICF) has been recommended to enable a broader and more holistic view of an individual's health condition. In addition, it works as an important reference for multiprofessional teams. In low-income countries, like Brazil, the attempts to systematize and incorporate the ICF model in health services has been a challenge.

Aim: The aim was to analyze the development of premature babies considering the biopsychosocial model of the ICF.

Design: A longitudinal study.

Setting: Maternity in the northeast Brazil.

Population: Thirty-five premature babies were evaluated in the first stage and 20 in the second.

Methods: Pre, perinatal, socioeconomic data and environmental factors were collected, and general movements assessed during the 38th (±1.79) week of corrected gestational age. The Age and Stages Questionnaire (ASQ-3) was used to assess child development, in the 13th (±1.50) month of life. The instruments were chosen with the objective of evaluating information necessary for the follow-up of premature infants and to represent the five domains of the ICF.

Results: Of the 35 newborns initially evaluated, 20 were reassessed at 1 year of age and 70% were boys. In the function and structure domain, 55% exhibited altered general movements and 35% grade 1 intraventricular hemorrhage; in activity and participation, 15% displayed delayed communication, 20% delayed ample motor coordination, 40% fine motor coordination and problem resolution and 35% personal/social delay in the ASQ-3. Only one item of the personal factors (male sex) and function and structure domain (intraventricular hemorrhage) exhibited an association with atypical child development.

Conclusions: Given the susceptibility of premature newborn neurodevelopment and the magnitude of the biopsychosocial model of the ICF, even at this early stage of life, it was possible to observe the influence of personal factors, body function and structure domains on atypical child development.

Clinical rehabilitation impact: The care for the premature newborn with global look of the classification of functioning, disability and health.

MeSH terms

  • Brazil
  • Child Development / physiology*
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • International Classification of Functioning, Disability and Health*
  • Longitudinal Studies
  • Male
  • Models, Biopsychosocial*
  • Pregnancy
  • Surveys and Questionnaires