Aşırı Düşük Doğum Ağırlıklı Prematüre Çocukların Okul Öncesi Dönemde Dünya Sağlık Örgütü Çocuk ve Ergenlerde Uluslararası İşlevsellik Sınıflamasında Belirlenen Alanlarda Sorun Yaşama Oranları ve Hizmet Gereksinimleri

Yıl 2021, Cilt: 11 Sayı: 2, 102 - 112, 25.08.2021

Berfin Uysal , Sultan Kavuncuoğlu

https://doi.org/10.26650/experimed.2021.927825

Öz

Amaç: Bu çalışmada, 1000 gram ve altında doğan ve 3-5 yaşına gelmiş çocukların, Dünya Sağlık Örgütü Çocuk ve Ergenlerde Uluslararası İşlevsellik Sınıflaması (ICF-CY) sisteminde belirlenen alanlarda sorunla karşılaşma oranları araştırılarak ve hizmet ihtiyaçlarının belirlenmesi amaçlanmıştır.

Gereç ve Yöntem: Elli sekiz çocuğa okul öncesi dönemde fizik muayene ve ayrıntılı nörolojik inceleme yapıldı. Bu çocuklar perinatal ve sosyodemografik özellikler yönünden irdelenerek tüm çocuklara Vineland Uyum ve Davranış Ölçeği uygulanmıştır. Sonuçlar ICF-CY modeline uyarlanmıştır.

Bulgular: Olgularımızın iletişim işlevselliğinde %20,6’sının, günlük yaşam becerilerine katılımında %12,1’inin, sosyalleşme işlevselliğinde %19’unun, hareket işlevselliğinde ise %29,3’ünün ciddi düzeyde sorun yaşadıkları saptanmıştır. Sadece 3 olguda ciddi düzeyde yaşla uyumlu olmayan davranış sorunu tanımlanmıştır. Hareket işlevselliğinin; öz bakım işlevselliğini, ev yaşamı etkinliklerine katılımı, sosyalleşme işlevselliğini, oyun ve boş zaman etkinliklerine katılımı, öğrenme ve problem çözme işlevselliğini anlamlı olarak etkilediği belirlenmiştir. Olgularımızın %22,4’ünün (13 olgu) yüksek seviyede özel eğitim desteğine ihtiyacı olduğu belirlenmiştir.

Tartışma: Günümüzde yaşama şansları oldukça yüksek olan aşırı düşük doğum ağırlıklı prematürelerin işlevsellik, etkinlik, yaşama katılım ve hizmet ihtiyaçlarının saptanabilmesi için uzun dönem izlemleri çok önemlidir ve mutlaka ergenlik dönemine kadar devam ettirilmelidir.

Anahtar Kelimeler

Prematüre, aşırı düşük doğum ağırlıklı, Dünya Sağ-lık Örgütü, Vineland, özel eğitim

Problem Rates and Service Requirements of Extremely Low Birth Weight Preschoolers in Areas Designated in the World Health Organization International Classification of Functioning in Children and Adolescents (ICF-CY ) System

Öz

Objective: Our aim in this study is to determine the problem rates and service requirements according to World Health Organization International Classification of Functioning in Children and Adolescents (ICF-CY) system defining specified areas as body structures, functionality, activity, participation in life and environmental factors in premature children born as <1000 and aged 3 to 5 years during the research process.
Materials and methods: Physical and neurological examination, perinatal and sociodemographic characteristics were examined in 58 premature born preschoolers and they were evaluated in terms of communication, socialization, movement and daily living skills with the Vineland Adaptation and Behavior Scale. Results were adapted to the ICF-CY model.
Results: Functionality problems of our cases were found as 20,6% in communication, 12,1% in participation in daily life skills, 19% in socialization and 29,3% in movement. Severe behavioral problems incompatible with age were identified in only 3 cases. Movement functionality was determined to significantly affect self-care functionality, participation in home life activities, socialization functionality, participation in games and leisure activities, learning and problem solving functionality. It was determined that 22.4% of our cases (13 cases) needed a high level of special education support.
Discussion: Long-term follow-up is very important in determining the functionality, efficiency, participation in life and service needs of extremely low birth weight premature babies whose survival rates are gradually increasing and should be continued with a multidisciplinary approach until adolescence.

Anahtar Kelimeler

Premature, extremely low birth weight, World Health Orga-nization, Vineland, special education

Kaynakça

• 1. Chung EH, Chou J, Brown KA. Neurodevelopmental outcomes of preterm infants: a recent literature review. Transl Pediatr 2020; 9 (Suppl 1): 3-8.
• 2. World Health Organization: International Classification of Functio-ning, Disability and Health, Geneva, WHO, 2001.
• 3. Sparrow SS, Cicchetti DV, Balla DA. Vineland adaptive behavior scales 2nd ed. AGS Publishing; Circle Pines, MN: 2005.
• 4. Rosenbaum P, Saiga S, Szatmari P, Hoult L. Vineland adaptive behavi-or scales as a summary of functional outcome of extremely low-birth weight children. Dev Med Child Neurol 1995; 37: 577-86. [CrossRef ]
• 5. De Battista AM, Huffman LC, Cooper B, Alkon A, Kennedy CM, We-iss SJ. Adaptive Behavior Trajectories in Children Born Prematu-rely: The infuence of biologic and social risk factors over the first few years of life. Ann Pediatr Child Health 2016; 4(2): 1101.
• 6. Pascal A, Govaert P, Oostra A, Naulaers G, Ortibus E, Van Den Broe-ck C. Neurodevelopmental outcome in very preterm and very-low birthweight infants born over the past decade: a meta-analytic review. Dev Med Child Neurol 2018; 60: 342-55. [CrossRef ]
• 7. The Scottish low birthweight study: II. Language attainment, cognitive status, and behavioural problems. Arch Dis Child 1992; 67: 682-6. [CrossRef ]
• 8. Sajaniemi N, Hakamies-Blomqvistb N, Katainenc S, Wendta L. Ear-ly cognitive and behavioral predictors of later performance: a fol-low-up study of ELBW children from ages 2 to 4. Early Child Res Q 2001; 16: 343-61. [CrossRef ]
• 9. Vohr BR, Msall ME. Neuropsychological and functional outcomes of very low birth weight infants. Seminars in perinatology 1997; 21: 202-20. [CrossRef ]
• 10. Chen PS, Jeng SF, Tsou KI. Developmental function of very-low-birth-weight infants and full-term infants in early childho-od. J Formos Med Assoc 2004; 103: 23-31.11. Sullivan MC, Msall ME. Functional performance of preterm child-ren at age 4. J Pediatr Nurs 2007; 22: 297-309. [CrossRef ]
• 12. Short EJ, Klein NK, Lewis BA, Fulton S, Eisengart S, Kercsmar C, et al. Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediat-rics 2003; 112: e359.
• 13. Voorman JM, Dallmeijer AJ, Van Eck M, Schuengel C, Becher JG. Social functioning and communication in children with cerebral palsy: association with disease characteristics and personal and environmental factors. Dev Med Child Neurol 2010; 52: 441-7. [CrossRef ]
• 14. Hack M, Friedman H, Fanaroff AA. Outcomes of extremely low birth weight infants between 1982-1988. N Eng J Med 1989; 321: 1642-7. [CrossRef ]
• 15. Msall ME, Rogers BT, Buck GM, Mallen S, Catanzaro NL, Duffy LC. Functional status of extremely preterm infants at kindergarten entry. Dev Med Child Neurol 1993; 35: 312-20. [CrossRef ]
• 16. Moore GP, Lemyre B, Barrowman N, Daboval T. Neurodevelopmen-tal outcomes at 4 to 8 years of children born at 22 to 25 weeks' gestational age: a meta-analysis. JAMA Pediatr 2013; 167: 967-74. [CrossRef ]
• 17. Palta M, Sadek-Badawi M, Evans M, Weinstein MR, McGuinnes G. Functional assessment of a multicenter very low-birth-weight co-hort at age 5 years. Newborn Lung Project. Arch Pediatr Adolesc Med 2000; 154: 23-30.
• 18. Dieterich SE, Hebert HM, Landry SH, Swank PR, Smith KE. Maternal and child characteristics that influence the growth of daily living skills from infancy to school age in preterm and term children. Ear-ly Education and Development 2004; 15: 283-304. [CrossRef ]
• 19. Delmas O, Garcia P, Bernard V, Fabre M, Vialet R, Boubred F, et al. Neurodevelopmental outcome at 3 years of age of infants born at less than 26 weeks. Arch Pediatr 2016; 23: 927-34. [CrossRef ]
• 20. Grunau RE, Whitfield MF, Fay TB. Psychosocial and academic cha-racteristics of extremely low birth weight (<800 g) adolescents who are free of major impairment compared with term-born control subjects. Pediatrics 2004; 114: 725-32. [CrossRef ]
• 21. Hamilton BE, Minino AM, Martin JA, Kochanek KD, Strobino DM, Guyer B. Annual summary of vital statistics: 2005 Pediatrics 2007; 119: 345-60.22. Marlow N, Wolke D, Bracewell MA, Samara M, for the EPICure Study Group. Neurologic and developmental disability at six years of age after extremely preterm birth. New Eng J Med 2005; 352: 9-19. [CrossRef ]
• 23. Johnson EO, Breslau N. Increased risk of learning disabilities in low birth weight boys at age 11 years. 2000; 47: 490-500.24. Vohr BR, Wright LL, Dusick AM, Mele l, Verter J, Steichen JJ, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the national institute of child health and human development neonatal research network, 1993-1994. Pe-diatrics 2000; 105: 1216-26. [CrossRef ]
• 25. Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cogni-tive and behavioral outcomes of school-aged children who were born preterm: a metaanalysis. Jama 2002; 288: 728-37. [CrossRef ]
• 26. Cheong, JLY, Burnett AC, Treyvaud K, Spittle AJ. Early environment and long-term outcomes of preterm infants. J Neural Transm 2020; 127: 1-8. [CrossRef ]
• 27. Hollebrandse NL, Spittle AJ, Burnett AC, Anderson PJ, Roberts G, Doyle LW, et al. School-age outcomes following intraventricular haemorrhage in infants born extremely preterm. Arch Dis Child Fetal Neonatal Ed 2021; 106: 4-8. [CrossRef ]
• 28. Hack M, Schluchter M, Cartar L, Rahman M, Cuttler L, Borawski E. Growth of very low birth weight infants to age 20 years. Pediatrics 2003; 37: 668-73. [CrossRef ]
• 29. Davidovitch M, Kuint J, Lerner-Geva L, Zaslavsky-Paltiel I,Rotem RS, Chodick G, et al. Postnatal steroid therapy is associated with autism spectrum disorder in children and adolescents of very low birth weight infants. Pediatr Res 2020; 87: 1045-51. [CrossRef ]