Comportamento do sono de crianças prematuras egressas da unidade neonatal

Abstract

Prematurity poses a series of risks to infant growth and development, among which, alterations in the constitution of sleep can cause disease or potentiate deficits resulting from preterm birth. The objective of this study was to evaluate the sleep behavior of children who were born prematurely from the Neonatal Unit of 12 to 18 months. A cross - sectional, exploratory and quantitative study carried out at the Specialized Outpatient Clinic of Pediatrics at the Hospital Complex of the Federal University of Ceará and at the Treatment and Early Stimulation Center from July / 2015 to February / 2016. Sample for convenience of 30 children from 12 to 18 months who were born premature and graduates of the neonatal unit and 30 main caregivers. Participants' characterization form, Infant Sleep Questionnaire (ISQ) and a diary of daily activities and sleep habits of the child were used in the collection. The data was organized in Microsoft Office Excel and analyzed by the Statistical Package for the Social Sciences, version 20.0. The mean, standard deviation and odds ratio and their 95% confidence intervals were calculated. For the association of the caregiver and neonatal variables with infant sleep, Chi-Square, likelihood ratio and Fisher's exact tests were used. For all tests, a significance level of 5% (p <0.05) was set. Study approved by the Research Ethics Committee of the Federal University of Ceará, according to CAAE 446786615.3.0000.5054. The variables of the caregiver that presented a significant association, according to the criteria of the total scores, of the ISQ caregiver and evaluator, were races other than parda (white, black, indigenous and yellow), marital status without companion, After 22h31min and to wake up between 5h00min and 6:59min hours and with total sleep duration per night from 4h00min to 5h59min. As for the child, gestational age at birth between 31 and 36 weeks, no use of antibiotic therapy during neonatal hospitalization, total duration of five to eight and a half hours of sleep per night, presence of naps throughout the day and sleep in the Parents were correlated with the altered behavior of infant sleep. Interventions for stimulating sleep, such as swinging the child in the hammock and feeding it just before bedtime, also had a significant association. The information collected by the characterization instrument were similar to those obtained in the sleep diary, however, the number of awakenings in the questionnaire was underestimated in relation to the diary. According to the records, most of the children slept in the hammock, accompanied by the caretaker, demonstrating on average an afternoon nap and a night awakening independent of unexpected external events. It was concluded that moderate and borderline premature infants from the neonatal unit are more at risk of altered sleep behavior than extreme premature infants. Similarly, behavioral variables and sleep habits of both caregivers and the child, such as sleeping and waking hours, total sleep duration and interventions to stimulate sleep, are more influential for the onset of changes in infant sleep than perinatal conditions. Therefore, it is suggested, on the part of the nurse, interventions of promotion of the health of the infant sleep directed to the family as a whole.