Background Due to small iron stores and rapid growth during the first months of life, infants with low birth weight (LBW) are at risk of iron deficiency (ID). ID in infancy is associated with irreversible impaired neurodevelopment. Preventive iron supplementation may reduce the risk of ID and benefit neurodevelopment, but there is also a possible risk of adverse effects. More than 50% of all LBW infants are born with marginally LBW (MLBW, 2000-2500g), and it is not known if they benefit from iron supplementation. Methods We randomized 285 healthy, Swedish, MLBW infants to receive 3 different doses of oral iron supplements; 0 (Placebo), 1, and 2 mg/kg/day from six weeks to six months of age. Iron status, during and after the intervention was assessed and so was the prevalence of ID and ID anemia (IDA), growth, morbidity and the interplay with iron and the erythropoetic hormones hepcidin and erythropoietin (EPO). As a proxy for conduction speed in the developing brain, auditory brainstem response (ABR) was analyzed at six months. In a follow up at 3.5 years of age, the children were assessed with a cognitive test (WPPSI-III) and a validated parental checklist of behavioral problems (CBCL), and compared to a matched reference group of 95 children born with normal birth weight. Results At six months of age, the prevalence of ID and IDA was significantly higher in the placebo group compared to the iron supplemented infants. 36% had ID in the placebo group, compared to 8% and 4 % in the 1 and 2mg/kg/day-groups, respectively. The prevalence of IDA was 10%, 3% and 0%, respectively. ABR-latencies did not correlate with the iron intake and was not increased in infants with ID or IDA. ABR wave V latencies were similar in all three groups. Hepcidin correlated to ferritin and increased in supplemented infants while EPO, which was negatively correlated to iron status indicators, decreased. At follow up there were no differences in cognitive scores between the groups but the prevalence of behavioral problems was significantly higher in the placebo group compared to those supplemented and to controls. The relative risk increase of CBCL-scores above a validated cutoff was 4.5 (1.4 – 14.2) in the placebo-group compared to supplemented children. There was no detected difference in growth or morbidity at any age. Conclusion MLBW infants are at risk of ID in infancy and behavioral problems at 3 years of age. Iron supplementation at a dose of 1-2 mg/kg/day from six weeks to six months of age reduces the risks with no adverse effects, suggesting both short and long term benefit. MLBW infants should be included in general iron supplementation programs during their first six months of life.

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 4 uppsatser. Även tryckt utgåva.

OBJECTIF: Chez les Autochtones, la relation entre le degré d'éloignement et les issues de naissance est inconnue. L’objectif de cette étude est d’évaluer cet impact parmi les Premières Nations du Québec. MÉTHODE : Nous avons utilisé les données vitales de Statistique Canada pour la province du Québec pour la période 1991-2000. L’ensemble des naissances géocodées parmi les communautés des Premières Nations groupées en quatre zones en se basant sur le degré d'éloignement a été analysé. Nous avons utilisé la régression logistique multi-niveaux pour obtenir des rapports de cotes ajustés pour les caractéristiques maternelles. RESULTATS : Le taux de naissances prématurées varie en fonction de l’éloignement de la zone d’habitation (8,2% dans la zone la moins éloignée et 5,2% dans la Zone la plus éloignée, P<0,01). En revanche, plus la zone est éloignée, plus le taux de mortalité infantile est élevé (6,9 pour 1000 pour la Zone 1 et 16,8 pour 1000 pour la Zone 4, P<0,01). Le taux élevé de mortalité infantile dans la zone la plus éloignée pourrait être partiellement expliqué par le fort taux de mortalité post-natale. Le taux de mort subite du nourrisson est 3 fois plus élevé dans la zone 4 par rapport à la zone 1. Cependant la mortalité prénatale ne présente pas de différences significatives en fonction de la zone malgré une fréquence élevée dans la zone 4. La morbidité périnatale était semblable en fonction de la zone après avoir ajusté pour l’âge, l’éducation, la parité et le statut civil. CONCLUSIONS : Malgré de plus faibles taux d’enfants à haut risque (accouchements prématurés), les Premières Nations vivant dans les communautés les plus éloignées ont un risque plus élevé de mortalité infantile et plus spécialement de mortalité post-néonatale par rapport aux Premières Nations vivant dans des communautés moins éloignées. Il y existe un grand besoin d’investissement en services de santé et en promotion de la santé dans les communautés les plus éloignées afin de réduire le taux de mortalité infantile et surtout post-néonatale. / OBJECTIVE: It is unknown whether Aboriginal birth outcomes may be affected by the degree of community remoteness. We assessed community remoteness and birth outcomes among Quebec First Nations. METHODS: We used Statistics Canada's vital data for the province of Quebec, 1991-2000. Postcode geo-coding linkage was used to identify all births in First Nations communities (reserves). Communities were grouped into four zones based on the degree of remoteness. Multilevel logistic regression was used to obtain the ORs adjusting for maternal characteristics. RESULTS: Preterm birth rates rose progressively from the most remote (5.2%) to the least remote (8.2%) zone (P<0.001). In contrast, infant mortality rose progressively from the least remote (6.9/1000) to the most remote (16.8/1000) zone (P<0.01). The excess infant mortality in the more remote zones could be largely explained by the high postneonatal mortality. Postnatal SIDS was 3 times higher in the most remote compared to the least remote zone. Perinatal mortality was highest in the most remote zone but the differences were not significant across the four zones. Similar patterns were observed after adjusting for maternal age, education, parity and marital status. CONCLUSIONS: Despite lower rates of preterm deliveries, First Nations living in more remote communities suffered a substantially higher risk of infant death, especially postneonatal death, compared to First Nations living in less remote communities. There is a greater need for improving maternal and infant health in more remote Aboriginal communities.

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

Made available in DSpace on 2016-06-02T20:44:09Z (GMT). No. of bitstreams: 1 4166.pdf: 640336 bytes, checksum: 80394a2355787e24b01541f7afc91b93 (MD5) Previous issue date: 2012-02-17 / Financiadora de Estudos e Projetos / The birth of a child preterm and with low birth weight is considered one of the main risk factors that can lead to changes and delays in neuro-psychomotor development. Among these changes are the difficulties in motor, learning, and visual-motor integration areas, as well as sensory and perceptive problems that alone or in combination, ultimately will impact the child's social participation, especially in carrying out activities of daily living, school and play. Considering playing as the main activity for children, this study aimed to investigate possible correlations between the performance of the ludic behavior of children with a history of preterm birth and their neuro-psychomotor development. We tried to understand this phenomenon in the pre-school period, in order to produce knowledge in a preventive perspective in relation to schooling. This study was approved by the Ethics Committee of Universidad Federal de São Carlos. It is a descriptive and correlational study involving 52 children divided into three groups: Study group GI (consisting of 12 children with a history of prematurity and low birth weight at risk of developmental delay detected), Study group GII (consisting for 14 children with a history of prematurity and low birth weight without developmental delay detected) and the comparison group GIII (without the mentioned history and with 26 children from the same socioeconomic class according to the classification made by the Criteria Questionnaire Brazil). Three methods were used to perform the evaluations: TSDD-II (Screening Test Denver II), the EPP-DP (teacher s perception scale on student s performance and participation in the school environment), and ELPK-rb (Knox s Pre-school Ludic Scale - Revised). The first test was used to compose samples, the second to raise the awareness of teachers of the development of children, and the latter to the specific assessment of ludic behavior. The data were analyzed quantitatively in order to verify the presence of significant differences in ludic behavior in the three groups. To verify the significance of possible associations between groups of preterm and term infants, with the results obtained from the TSDD-II, we chose Fisher s Exact Test. After verifying the association between the variables of interest, we used the Kruskal-Wallis Test in order to ascertain whether or not differences exist between the scores obtained by the classes of variables in the ELPK-rb participation fields. The results of this study revealed that from a detailed analysis of the play behavior of children, that is, the way the play you can identify the presence of changes in global development, as well as in more specific areas of human development. Regarding the performance of children with a history of prematurity ande risk for developmental delay 8% had unsatisfactory results and 17% were assessed as having a partially satisfactory performance, something that was not repeted in the other groups analyzed, which had in most cases very satisfactory performances. A similar picture was observed when analyzing the performance of children in fine motor activities, where children with a history of prematurity had inferior performances to those of children born at term, principally when comparing the results obtained from children of group GI with those obtained from children in group GIII. Regarding the results obtained in evaluating the ELPK-rb participation field, lmost all children from groups GI, GII and GIII presented co-operative play behavior, or would rather play only with other children. Another factor that draws our attention when observing the results of participation fields, was the presence of a greater difficulty for children with a history of prematurity and risk for developmental delay in playing games with simple rules (being that 17% did not show the expected behavior and 25% played tentatively). Still with respect to the participation field, when analyzing the results related to the language area it was observed, again, a lower performance among children with a history of prematurity, especially among children in group GI, when compared to children born at term. Regarding the children s performance in the ELPK-rb field of make believe/symbolic games, it was noted that children of the group GI obtained results lower tah those of children from GII and GIII, especially in sub-items interprets more complex emotions and demonstrates function in the games for or with others . By establishing the association between the results obtained by the groups in ELPK-rb, with those presented in TSDD-II, it was observed that there are changes in play behavior of children with a history of prematurity, due to possible delays in neuro-psychomotor development, once working with all comparisons involved, the results presented by children in strata 1 (with a history of prematurity and risk for developmental delay) differed from the children in strata 4 (born at term and with the presence of caution ). However, we cannot say that the presence of risk for developmental delay detected by TSDD-II, as well as changes in play behavior of children are unique conseqyuences of prematurity, but that they results from multiple factors that add up and influence, concomitantly, the development of motor, cognitive, psychological, and social skills of children. It is confirmed then, that pratical education, health, and social skills of children. It is confirmed then, that pratical education, health, and the promoting of development occur in conjunction, contributing to the detection of risk factors and promoting the quality of interactions and the environment in which children are placed. In this sense, it is necessary to invest in the training of educators/caregivers/pages, since they can provide protective factors in children s development, minimizing/offsetting the negative effects arising from the presence of social and biological risk factors through play, as this constitutes one of the main activities performed by children in preschool, and whose primary essence is the promotion of cognitive and bio-psychomotor development in the subjects. To give children opportunities to play is to give them much more than the act itself, because it provides to each of them a better perspective of life and natural and healthy development. / O nascimento da criança pré-termo é considerado um dos principais fatores de risco que pode levar às alterações e atrasos no desenvolvimento neuropsicomotor. Dentre estas alterações estão as dificuldades nas áreas motoras, de aprendizagem, da integração visomotora, problemas sensoriais e perceptivos que isolados ou de forma combinada, acabam por repercutir na participação social da criança, especialmente na realização das atividades da vida diária, escolar e no brincar. Considerando-se o brincar como uma das principais atividades infantis, o presente estudo teve por objetivo investigar possíveis associações entre o desempenho do comportamento lúdico de crianças com histórico de prematuridade ao nascimento e seu desenvolvimento neuropsicomotor. Buscou-se compreender este fenômeno na etapa pré-escolar, ou seja, no momento exato em que antecede a escolaridade formal (ingresso no ensino fundamental) a fim de se produzir conhecimentos numa perspectiva preventiva em relação à escolarização. A presente pesquisa fora aprovada pelo Comitê de Ética da Universidade Federal de São Carlos. Trata-se de um estudo analítico, observacional, e de coorte retrospectivo, composto por 52 crianças distribuídas em três grupos: Grupo de estudo GI (constituído por 12 crianças com histórico de prematuridade e baixo peso ao nascimento com risco para atraso no desenvolvimento detectado); Grupo de estudo GII (constituído por 14 crianças com histórico de prematuridade e baixo peso ao nascimento sem atraso no desenvolvimento detectado) e o Grupo Comparado-GIII (sem o referido histórico) composto por 26 crianças pertencentes a mesma classe socioeconômica de acordo com a classificação realizada por meio do Questionário Critério Brasil). Para realização das avaliações foram utilizados três instrumentos: TSDD-II (Teste de Triagem Denver II), a EPPDP (Escala de percepção dos professores sobre o desempenho e participação do aluno no ambiente escolar), e a ELPK-rb (Escala Lúdica Pré-escolar de Knox-Revisada). O primeiro instrumento foi utilizado para definir a composição das amostras, o segundo com o objetivo de aferir a percepção dos professores frente ao desenvolvimento das crianças, e o último para realizar a avaliação específica do comportamento lúdico. Os dados coletados foram analisados de forma quantitativa, no intuito de se verificar a presença de diferenças significativas no comportamento lúdico em relação aos três grupos. Para verificar a significância de possíveis associações entre os grupos de prematuros e crianças nascidas a termo, com os resultados obtidos a partir do TSDD-II, optou-se pelo Teste Exato de Fisher. Depois de verificada a associação entre as variáveis de interesse, foi empregado o teste de Kruskal-Wallis no intuito de verificar a existência, ou não, de diferenças entre os escores obtidos pelas classes de variáveis analisadas, nos domínios da ELPK-rb. Os resultados deste estudo revelaram que a partir de uma análise detalhada do comportamento lúdico das crianças, ou seja da maneira como elas brincam, é possível identificar a presença de alterações no desenvolvimento global, como também em áreas mais específicas do desenvolvimento humano. Em relação ao desempenho das crianças nas atividades que envolvem a coordenação motora global, observou-se que entre as crianças com histórico de prematuridade e risco para atraso no desenvolvimento 8% obtiveram resultados insatisfatórios e 17% foram avaliadas como tendo um desempenho parcialmente satisfatório, o que não se repetiu nos demais grupos analisados, os quais obtiveram na maioria dos casos rendimento muito satisfatórios. Um quadro semelhante foi observado ao se analisar o desempenho das crianças nas atividades motoras finas, onde as crianças com histórico de prematuridade apresentaram um desempenho inferior aos das crianças nascidas a termo, principalmente ao se comparar os resultados obtidos pelas crianças do grupo GI com os obtidos pelas crianças do grupo GIII. Em relação aos resultados obtidos na avaliação do domínio da participação da ELPK-rb, a quase totalidade das crianças dos grupos GI, GII e GIII apresentaram um brincar cooperativo, ou seja, preferiam brincar com outras crianças do que só. Outro fator que nos chama a atenção ao observar os resultados referentes ao domínio da participação, foi a presença de uma maior dificuldade das crianças com histórico de prematuridade e risco para atraso no desenvolvimento em participar de jogos com regras simples (uma vez que 17% não apresentaram o comportamento esperado e 25% o realizaram de forma hesitante). Ainda com relação ao domínio da participação, ao se analisar os resultados referentes à área da linguagem observou-se, novamente, um desempenho inferior entre as crianças com histórico de prematuridade, principalmente entre as crianças do grupo GI, quando comparadas às crianças nascidas a termo. Sobre o desempenho das crianças no domínio do faz-de-conta/jogo simbólico da ELPK-rb, notou-se que as crianças do grupo GI obtiveram resultados inferiores aos das crianças dos grupos GII e GIII, principalmente nos subitens interpreta emoções mais complexas e desempenha função nas brincadeiras para/ou com os outros . Ao realizar a associação entre os resultados obtidos pelos grupos na ELPK-rb, com os apresentados no TSDD-II, observou-se que há alterações no comportamento lúdico das crianças com histórico de prematuridade, decorrentes de possíveis atrasos no desenvolvimento neuropsicomotor, uma vez em todas as comparações realizadas, os resultados apresentados pelas crianças do estrato 1 (com histórico de prematuridade e risco para atraso no desenvolvimento) diferiram das crianças do estrato 4 (nascidas a termo e com presença de cautelas ). No entanto, não é possível afirmar que a presença de risco para atraso no desenvolvimento detectado pelo TSDD-II, bem como as alterações no comportamento lúdico das crianças sejam conseqüências exclusivas da prematuridade, mas sim que são decorrentes de múltiplos fatores que se somam e influenciam, concomitantemente, no processo de desenvolvimento das habilidades motoras, cognitivas, psicológicas, e sociais das crianças. Confirma-se, então, a necessidade das práticas de educação, saúde e promoção do desenvolvimento ocorrer em conjunto, contribuindo para a detecção de fatores de risco e para a promoção da qualidade das interações e do ambiente em que as crianças encontram-se inseridas. Neste sentindo, é necessário realizar investimentos na capacitação de educadores/cuidadores/pajens, uma vez que estes podem constituir-se em fatores protetivos ao desenvolvimento das crianças, minimizando/anulando os efeitos negativos advindos da presença de fatores de riscos sociais e biológicos mediante a estimulação das habilidades que englobam o desenvolvimento infantil, principalmente através do brincar, já que este se constitui como uma das principais atividades realizadas pelas crianças em idade pré-escolar, e cuja essência primordial é a promoção do desenvolvimento biopsicomotor e cognitivo dos sujeitos. Ao oferecer às crianças a possibilidades de brincar, dá-se a estas muito mais que o ato em si mesmo, pois proporciona-se a cada uma delas uma perspectiva melhor de vida e um desenvolver de forma natural e saudável.

There is no consensus about the hemodynamic significance and, therefore, the need to treat a persistent ductus arteriosus in preterm newborns. Since the diagnosis of a hemodynamically significant persistent ductus arteriosus (hsPDA) is made by a summary of non-uniform echo-criteria in combination with the clinical deterioration of the preterm neonate, standardized clinical and ultrasound scoring systems are needed. The objective of this study was the development of a clinical score for the detection and follow-up of hsPDA. In this observational cohort study of 154 preterm neonates (mean gestational age 28.1 weeks), clinical signs for the development of hsPDA were recorded in a standardized score and compared to echocardiography. Analyzing the significance of single score parameters compared to the diagnosis by echocardiography, we developed a short clinical score (calculated sensitivity 84% and specificity 80%). In conclusion, this clinical diagnostic PDA score is non-invasive and quickly to implement. The continuous assessment of defined clinical parameters allows for a more precise diagnosis of hemodynamic significance of PDA and, therefore, should help to detect preterm neonates needing PDA-treatment. The score, therefore, allows a more targeted use of echocardiography in these very fragile preterm neonates.

Objetivos: avaliar a prevalência de alterações auditivas em recém-nascidos de muito baixo peso na Unidade de Tratamento Intensivo Neonatal do Hospital de Clínicas de Porto Alegre e estudar as variáveis que possam estar relacionadas com as alterações da acui-dade auditiva. Métodos: foi realizado um estudo transversal que incluiu todos os recém-nascidos de muito baixo peso admitidos na Unidade de Tratamento Intensivo Neonatal do Hospital de Clínicas de Porto Alegre no período de 1o de setembro de 2001 a 31 de janeiro de 2002. To-dos os pacientes foram submetidos ao exame de otoemissão acústica evocada por produto de distorção no momento da alta hospitalar. O exame foi repetido em 30 dias quando havia alte-ração no primeiro exame. Quando o paciente apresentava o exame de otoemissão acústica al-terada em duas ocasiões, era realizado o potencial auditivo evocado cerebral, considerado al-terado a partir de 35 dB NA. Resultados: foram estudados 96 recém-nascidos. Seis tiveram tanto o exame de otoemissão acústica quanto o potencial auditivo evocado cerebral alterados. A média da idade gestacional foi de 31,5 ± 2,6 semanas, o peso de nascimento variou de 640 a 1.500 g e 57,3% dos pacientes eram do sexo feminino. A idade gestacional e o índice de Apgar no 5o minuto foram inferiores no grupo otoemissão acústica e potencial auditivo evocado cerebral alterados em relação aos demais grupos, atingindo significância limítrofe. Conclusões: a prevalência de perda auditiva nos recém-nascidos de muito baixo peso da Unidade de Tratamento Intensivo Neonatal do Hospital de Clínicas de Porto Alegre foi de 6,3%, tendo sido observadas associações de significância limítrofe com idade gestacional e índice de Apgar no 5o minuto. / Objectives: to evaluate the prevalence of hearing loss in very low birth weight patients in the Neonatal Intensive Care Unit of the Hospital de Clínicas de Porto Alegre and to study the variables that can be related to hearing loss. Methods: a transversal study was carried through including all very low birth weight neonates admitted in the Neonatal Intensive Care Unit of the Hospital de Clínicas de Porto Alegre during September 1, 2000 to January 31, 2002. All patients were undergone to the distortion evoked otoacoustic emission test in the hospital discharge. When the patient presented alteration in this test, it was repeated in 30 days. However, when the patient who presented pathologic otoacoustic emission on two ocasions was undergone to the auditory evoked brain response. This test was considered abnormal from 35 dB NA. Results: we studied 96 neonates. Six children presented alteration in the distortion evoked otoacoustic emission test as well in the auditory evoked brain response. The children age average was 31.5 ± 2.6 weeks, their birth weight was between 640 g and 1,500 g, and 57.3% of the patients were female. The gestational age and the Apgar score at 5 minutes were inferior in the otoacoustic emission and auditory evoked brain response abnormal group related to the other groups, reaching bordering significance. Conclusions: the hearing loss prevalence of the very low birth weight neonates from the Neonatal Intensive Care Unit of the HCPA was 6.3%, and it was observed bordering significance associations related to gestational age and 5 minutes Apgar score.

INTRODUÇÃO: A restrição do crescimento intrauterino (RCIU) é conhecida como uma condição na qual o feto não consegue desenvolver todo o seu potencial de crescimento intrínseco. Crianças com RCIU em idade escolar têm prejuízos no aprendizado, memória, atenção e cognição em geral, e maior predisposição a transtornos psicológicos como Transtorno de Déficit de Atenção e Hiperatividade (TDAH), quando comparados com crianças não restritas. OBJETIVO: este estudo busca encontrar modificações neurobiológicas encefálicas, em ratos Wistar adolescentes, que possam explicar os efeitos, em parâmetros comportamentais, de neuroplasticidade e memória, da RCIU por redução da pressão de perfusão uterina (RPPU). MÉTODOS: ratas Wistar prenhes de 75 dias de idade foram submetidas à RPPU no dia gestacional 14, período que corresponde ao inicio da fase de rápido crescimento, diferenciação e maturação em ratos, por meio da colocação de um clipe na artéria aorta abdominal descendente antes da bifurcação para as artérias ilíacas e um clipe em cada artéria ovariana. O grupo Sham foi submetido à laparotomia exploratória sem a RPPU e o grupo controle não foi submetido a nenhum procedimento cirúrgico. Ratos Wistar de 30 dias, provenientes de mães submetidas à RPPU, Sham ou Controles, foram submetidos ao Teste de Campo Aberto, para avaliação da atividade locomotora e exploratória, e no 32º dia pós-natal (DPN) foram submetidos ao teste de Reconhecimento do Novo Objeto para avaliar a memória de longo prazo. Os encéfalos da prole foram coletados no 34º DPN e conservados para análise. A Técnica de imunoistoquímica foi realizada para mensurar a expressão de marcadores celulares neurais: NeuN (neurônios maduros) GFAP (astrócito) no córtex pré-frontal e estriado da prole. RESULTADOS: a RPPU causou diminuição no peso ao nascimento no grupo RCIU e Sham, porém não houve diferença no peso entre os grupos no 30º DPN. A RPPU aumentou significativamente a duração da gestação no grupo RCIU em um dia. Os animais restritos apresentaram aumento na atividade exploratória no teste de campo aberto. RCIU e Sham apresentaram déficit de memória no teste de reconhecimento do novo objeto. Associado a essas alterações comportamentais, a RCIU levou a o aumento significativo na expressão de NeuN no CPF e de GFAP no estriado no 34º DPN. CONCLUSÃO: a RPPU produz alterações na gravidez causando maior duração da ges-tação e RCIU na prole, conduzindo a modificações comportamentais e de memória, assim como a nível encefálico celular, promovendo novas perspectivas sobre as consequências do modelo em ratos de RCIU-RPPU. São necessários mais estudos para desvendar se essas modificações continuam presente na vida adulta dos ratos. / INTRODUCTION: Intrauterine growth restriction (IUGR) is known as a condition where the fetus cannot develop its intrinsic growth potential. IUGR Children in early scholar age have impaired learning abilities, memory, attention and cognitive deficit in general; also, they are in higher risk of psychological disorders as Attention Deficit and Hyperactivity Disorder (ADHD) when compared with non-IUGR children. OBJECTIVE: The study aims to find neurobiologi-cal brain modifications, in adolescent Wistar rats, that could clarify these memory and behav-ioral impairments in a rat animal model of IUGR by Reduced Uterine Perfusion Pressure (RUPP). METHODS: 75 days-old pregnant Wistar rats were underwent to RUPP procedure on 14th gestational day, period where the fast growing, differentiation and maturation phase begins in rats, by putting one clip at the abdominal descendent aorta before iliac bifurcation and one clip in each ovarian artery. The Sham group underwent exploratory laparotomy procedure without the RUPP and the control group was not exposed to any surgical procedure. 30 days old Wistar rats from RUPP, Sham, and Control mothers were exposed to the Open Field Test to assess the locomotor and exploratory activity and, at 32th postnatal day (PND), to the Novel Object Recognition test to assess the long-term memory. Offspring brains were collected at 34th PND and preserved for analysis. Immunohistochemistry technique was performed to measure the expression of neural cells markers: NeuN (mature neurons) and GFAP (astrocytes) in prefrontal cortex and striatum on the offspring. RESULTS: RUPP caused a decreased birth weight in IUGR and Sham group, however there was no difference between birth weight at 30th PND. RUPP significantly increased gestation in 1 day in IUGR rats. IUGR animals had greater exploratory, locomotor activity in the Open Field test. IUGR and Sham showed memory deficit in the Novel Object Recognition test. Associated to those behavioral modifications, the RUPP leaded to a significant increase in expression of NeuN and GFAP marker in prefrontal cortex and striatum at PND34. CONCLUSIONS: The RUPP dis-turbs pregnancy increasing gestation length and inducing IUGR in the offspring; which leads to behavioral and memory modifications, also, in a brain cellular level, promoting new insight about the IUGR-RUPP rat model consequences. Further analysis are needed to find whether this changes are still present in adult life.

Die doel van hierdie studie is die ontwikkeling van 'n ouerleidingsprogram vir moeders wat hul premature babas in 'n kangaroemoedersorgprogram versorg. Die program het ten doel om die moeders in die onmiddelikke versorging, sowel as die toekomstige begeleiding van hut kinders, toe te rus. 'n Literatuuroorsig word gegee van prematuriteit as fenomeen en van kangaroemoedersorg (KMS) as versorgingswyse, met spesifieke verwysing na die toepassing daarvan in Kalafonghospitaal. Die grondslae van ouerteiding word uit die literatuur opgesom en riglyne word ook gestef vir die samestelling van 'n ouerfeidingprogram. Die kwalitatiewe navorsingsmetode word gebruik om die inhoud van die ouerfeidingsprogram te bepaal en om ondersoek in te stel na die mees geskikte aanbiedingswyses. Die verslag word afgesluit met riglyne vir die samestelling van 'n prakties-toepasbare ouerleidingsprogram waarin inhoudsmoontlikhede, idees vir aanbieding en wyses vir die bepaling van gestelde uitkomste uiteengesit word. / The aim of this study is the development of parental guidance for mothers who take care of their premature babies in a programme of Kangaroo Mother Care. The programme aims to equip mothers for immediate and future care of their children. A literature review of prematurity as phenomenon and of kangaroo mother care as care method is presented with specifK: reference to the way it is applied in Kalafong-hospital. The basics of parental care are summated from literature and guidelines are set to design a parental guidance programme. The qualitative research method is put into operation to determine the content of the parental guidance programme and to investigate the most appropriate method of presentation. The report is concluded with guidelines for setting up a practical and applicable parental guidance programme in which subject possibilities, ideas for presentation and means for determining set outcomes are explained. / Educational Studies / M.Ed.(Spesialisering in voorligting)