Desenvolvimento neuropsicomotor em crianças de 12 meses pertencentes à Coorte de Nascimentos de 2015 de Pelotas, RS

Abstract

Child neurodevelopment is a complex process subject to intrinsic and extrinsic factors from the molecular events of gene expression to environmental inputs. Scientific evidence confirms that experiences during the prenatal period influence the child's capacity to respond to environmental demands, impacting on child's functionality. However, most of the studies about neurodevelopment have assessed the effect of exposure to chemical substances, use of vitamins and maternal diseases during pregnancy on child neurodevelopment at 24 months of age or more. Despite scientific interest during the last years about physical activity during pregnancy and the potentially beneficial effects on the child's well-belling, few studies have assessed the association between physical activity during pregnancy and offspring’s neurodevelopment. Thus, the purpose of this doctoral dissertation was to assess the association between sociodemographic characteristics, as well as, physical activity during pregnancy, with child neurodevelopment at 12 months in children from the 2015 Pelotas Birth Cohort. For this purpose, three original articles compose this dissertation. A systematic review of the literature on the association between physical activity during pregnancy and offspring neurodevelopment, that suggests that leisure-time physical activity practice may have a positive association with offspring’s language neurodevelopment. One original article including 3,747 infants from the birth cohort with complete information and in whom suspected neurodevelopment delay was assessed. The instrument used was the Oxford Neurodevelopment Assessment (Ox-NDA) tool. Results showed that among boys, higher maternal education was protective against language (OR=0.49 95%CI: 0.33;0.73) and motor suspected delays (OR=0.51 95%CI: 0.32;0.85). Among girls, higher maternal age increased the risk of suspected delay in motor domain (OR=2.98, 95%CI: 1.59; 5.63) and in the general score (OR=2.61, 95%CI: 1.46; 4.69). Birthweight ≥3500 grams, both for boys and girls was protective against suspected motor delay (OR=0.44, 95%CI 0.25;0.78; OR=0.35, 95%CI 0.20;0.61, respectively) and the global score (OR=0.37, 95%CI: 0.22; 0.64; OR=0.32, 95%CI: 0.20; 0.50). In adjusted analyses, a protective effect of the recommended self-reported leisure time physical activity (≥150 minutes/week) over suspected developmental delay (global score) was observed among boys (OR=0.50; 95%CI 0.28-0.88). In addition, boys whose mothers were at the second tertile of daily moderate-vigorous physical activity (MVPA) (as assessed by accelerometry) had 44% lower odds for suspected language developmental delay. Girls from mothers in the second tertile of daily MVPA (as assessed by accelerometry) presented a lower odds ratio for suspected motor delay (OR= 0.52; 95%CI 0.28-0.97).In summary, we can be concluded that maternal sociodemographic characteristics and new born characteristics, as well as, physical activity during pregnancy are associated with suspected development delay at 12 months. However, this association varies according to child’s sex and neurodevelopment domain. These findings have a significant importance to the field of public health because it suggests that physical activity practice during pregnancy may be a protective factor for suspected development delay.