Experiências adversas na primeira infância e desenvolvimento neuropsicomotor: abordagem populacional no Ceará

Abstract

Introduction : Adverse Childhood Experiences (ACE) that arise in the social and family environment act negatively on Child Development (CD) through toxic stress. Objective : Was to investigate how adverse experiences in early childhood influence the neuropsychomotor development of children in the state of Ceará. Methods : A cross sectional study with a population based quantitative, analy tical approach with state reach. Was analyzed data from the sixth edition of the Maternal a nd Child Health Survey in Ceará , focusing on DI (classified through the Ages and Stages Quetionnaires third edition ASQ 3), held in 2017 throughout the state of Ceará. Households with children from 0 to 6 years old and women from 10 to 49 years old were investigated, with multiple stage sampling, stratified, systematized and by cluster, made up of 3,200 households and 3,566 children. The analyzes were performed using the Statistical Package for Social Science software (version 23.0), with a sign ificance level of 0.05. In multivariate analysis multinomial logistic regression was used. Results : Was found a 17.5% prevalence of CD delay in the general classification of ASQ 3, at different levels of involvement in the domains: communication (3.2%), gl obal motor skills (3.5%), motor fine (6.3%), problem solving (5.9%) and personal social (6.1%). Was observed the male sex with 60% (p <0.001) more likely to have some delay in CD, children of illiterate mothers are 4 times more likely to delay (p <0.003), as well as 2 times more likely in the presence of malnutrition (p <0.020), with an 8% increase in delay (p <0.019) per year of age. Regarding ACE, an 83% higher probability of delay in the presence of alcohol or drug abuse was observed (p <0.001); 61% high er in neglect conditions (p <0.001); 43% more in the low socioeconomic class (p <0.002); 34% higher in maternal depression (p <0.018); and 36% in events such as death, unemployment, prison, illness / serious accident and / or marital separation (p <0.004). In the presence of 4 or more ACE, there was greater delay in all domains, especially in problem solving (p <0.001), fine motor skills (p <0.002) and personal social (p <0.001). Conclusion : Children in early childhood are more susceptible to delayed neurop sychomotor development in the presence of precarious socio economic environments, family contexts fragiled by risky behaviors and lack of positive environments, family contexts fragiled by risky behaviors and lack of positive parentingparenting.