Low birth weight, family income and paternal absence as risk factors in neuropsychomotor development

Abstract

Introduction: The first years of life are crucial to neuropsychomotor development (NPMD), during this period children are susceptible to organic, environmental or activity-related influences that may represent protective or risk factors towards full development, with potential lifelong repercussions.Objective: This study aimed to investigate and verify the risk factors in the neuropsychomotor development (NPMD) of children aged from zero to three years, attending public early childhood education centers.Methods: Cross-sectional study, contextual approach – based on ICF (International Classification of Functioning, Disability and Health) –, Denver II developmental screening test and additional assessments about nutritional status. For the analysis, a logistic regression was performed. The International Classification of Functioning, Disability and Health (ICF) concerning body functions and structure (evaluation questionnaire), activity and participation (evaluation of NPMD in school), personal factors (family characteristics), and environmental factors (characteristics of the ECECs) were considered for the evaluation phase. The instruments consisted of a questionnaire containing items to elicit information about the child, including current, neonatal and family traits.  For the evaluation DPMD, the Denver II test was used.  Inter- and intra-rater reliability was established using Cohen's kappa, and data subsequently submitted to stepwise (backward) regression analysis using a Logit model, using binary responses. The construction of an ROC (Receiver Operating Characteristic) to define the explanatory profile of the model built also was included, in addition to the calculation of the Odds Ratio (OR), the odds of chance occurrence the association of a given variable with DPMD.Results: NPMD was within the normal parameters, in 68.8% (n = 53) and risk of delays was in 31.2% (n = 24). The area with the best performance was the fine motor-adaptive (3.75%) and the most questionable one was the language (57.5%). It was verified that 48% (n=37) of the children had normal weight while 52% (n = 40) presented some nutritional risk. Low birth weight (OR = 181), monthly family income (OR = 9) and paternal absence (OR = 34) were statistically significant factors on the risk of NPMD delays.Conclusion: low birth weight, family income and paternal absence are factors associated with risks of NPMD delays. These findings reinforce the systemic and multifactorial nature of NPMD and emphasize the need for monitoring and formulating public policies -- especially the ones dedicated to children with low income conditions --, which could contribute to the full development of children, since public early childhood education centers should be transforming agents in the quality of child development.