Avaliação do desenvolvimento neuromotor e funcional de crianças submetidas à correção intra-uterina da mielomeningocele

Abstract

Introduction: Myelomeningocele (MMC) is the most common and serious type of spina bifida, a congenital anomaly that occurs due to a failure in the closure of the neural tube. MMC causes neurological, motor and sensory deficits. Because of this, children affected by this condition experience delays in neuromotor development, which impacts functional independence. Objective: To characterize the clinical picture and neuromotor and functional development of children diagnosed with myelomeningocele who underwent intrauterine correction surgery. Methods: This is an observational cross-sectional cohort study, quantitative in nature. The research was approved by the Research Ethics Committee of the Universidade Federal do Ceará and Maternidade Escola Assis Chateaubriand. Data collection took place between October 2020 and November 2023 through initial assessments; In addition, scales were applied (Hammersmith Infant Neurological Assessment and Bayley III Scale of Infant and Toddler Development) with the aim of evaluating motor, cognitive and language development. Results: 15 children diagnosed with myelomeningocele participated in the study; the average age of the sample was 37 months (±9.7). MMC correction surgeries occurred, on average, in the 25th week of pregnancy. 80% of births occurred before 37 weeks of gestation, which characterizes prematurity. 73% of children had a functional level below the anatomical level of the spinal cord injury, which is a prognosis of better neuromotor development and a greater likelihood of walking. 73% use orthoses to help maintain the standing position and gait training. According to the results obtained in the assessments, all children present cognitive, motor or language deficits. Conclusion: Both assessments point to delays in the motor development of the children studied. However, these deficits are not serious and more than half of infants are able to walk. In relation to cognitive and language, the results were also below expectations.