Developmental surveillance in primary health care: absence of child development milestones and associated factors

Solís-Cordero, Katherine; Palombo, Claudia Nery Teixeira; Duarte, Luciane Simões; Munhoz, Rebeca Ishi; Toriyama, Aurea Tamami Minagawa; Borges, Ana Luiza Vilela; Fujimori, Elizabeth

doi:10.1590/1806-93042020000400002

Katherine Solís-Cordero E-mail: katherine.solis22@usp.br

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0002-6012-0245

Claudia Nery Teixeira Palombo

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0002-0651-9319

Luciane Simões Duarte

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0001-9173-607X

Rebeca Ishi Munhoz

Hospital Alemão Oswaldo Cruz. São Paulo, SP, Brasil.

https://orcid.org/0000-0003-0163-1122

Aurea Tamami Minagawa Toriyama

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0003-0288-5714

Ana Luiza Vilela Borges

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0002-2807-1762

Elizabeth Fujimori

Escola de Enfermagem. Universidade de São Paulo. Av. Dr. Eneas de Carvalho Aguiar, 419. Cerqueira Cesar. São Paulo, SP, Brasil. CEP: 05.403-000.

https://orcid.org/0000-0002-7991-0503

E-mail: katherine.solis22@usp.br

Authors’ contribution Solís-Cordero K: data analysis, interpretation of results, writing, formatting and review of the article. Palombo CNT: conception and design of the project, data collection and writing of the article. Duarte LS:data collection, data analysis, interpretation of results and writing of the article. Munhoz RI: data collection and contributed to the writing of the article. Toriyama ATM and Borges ALV: writing and critical review of the content of the article. Fujimori E: project orientation, writing and review of the article. All the authors approved the final version of the article.

Aspects	N	%
Child
Age (months)
Mean (SD)	12.0 (9.8)
< 12	202	60.5
12 ├ 24	78	23.3
≥ 24	54	16.2
Sex
Male	183	54.8
Female	151	45.2

Nutritional
Birthweight (grams)^* * Information was not obtained for the entire sample.
< 2500	33	10.2
≥ 2500	292	89.8
Nutritional status^* * Information was not obtained for the entire sample.
Eutrophy	222	67.9
Excess of weight	89	27.2
Low weight	16	4.9
Anemia (≥ 6 months of age)^* * Information was not obtained for the entire sample.
Not anemic	121	58.5
Anemic	86	41.5
Breastfeeding at the time of the interview (< 24 months of age)^* * Information was not obtained for the entire sample.
Yes	168	61.3
No	106	38.7
Introduction of complementary feeding^* * Information was not obtained for the entire sample.
Timely	51	18.8
Not timely	220	81.2

Child development
Global child development
Present	160	47.9
Absent	174	52.1
Fine motor domain of child development
Present	236	70.7
Absent	98	29.3
Gross motor domain of child development
Present	249	74.5
Absent	85	25.5
Social domain of child development
Present	256	76.9
Absent	77	23.1
Psychic domain of child development
Present	271	81.4
Absent	62	16.6

Aspects	N	%
Socio-environmental ^* * Information was not obtained for the entire sample.
Maternal age (years)
Mean (SD)	27.2 (6.7)
< 20	39	12.1
20 ├ 35	232	72.3
≥ 35	50	15.6
Maternal education (years of study)
Mean (SD)	10.0 (3.2)
≤ 8	111	33.6
> 8	219	66.4
Maternal work outside the home
No work	204	61.6
Work	127	38.4
Well-child care at the health center
Yes	292	91.8
No	26	8.2
Child attendance at daycare
No attendance	292	87.7
Attendance	41	12.3
Place of stay of the child who does not attend daycare
Parents' house	263	90.7
Another place	27	9.3
Primary caregiver of the child who does not attend daycare
Mother	261	88.2
Others	35	11.8
Daily time (hours) of television exposure (>1 year of age)
Mean (SD)	1.6 (2.0)
< 1	31	25.2
≥ 1	92	74.8

Aspects	Domains of child development
	Fine motor				P ^* * Chi-square test;	Gross motor				P ^* * Chi-square test;
	Presence of all milestones		Absence of one or more milestones			Presence of all milestones		Absence of one or more milestones
	N	%	N	%		N	%	N	%
	236	70.7	98	29.3		249	74.5	85	25.5
Age (months)					<0.001					<0.001
< 12	145	71.8	57	28.2		176	87.1	26	12.9
12 ├ 24	69	88.5	9	11.5		52	66.7	26	33.3
≥ 24	22	40.7	32	59.3		21	38.9	33	61.1
Sex					0.063					0.249
Male	137	74.9	46	25.1		141	77.1	42	22.9
Female	99	65.6	52	34.4		108	71.5	43	28.5
Well-child care at the health center^† † Information was not obtained for the entire sample.					0.635					0.055
Yes	204	69.9	88	30.1		219	75.0	73	25.0
No	17	65.4	9	34.6		15	57.7	11	42.3
Child attendance at daycare^† † Information was not obtained for the entire sample.					0.137					0.176
No attendance	202	69.2	90	30.8		221	75.7	71	24.3
Attendance	33	80.5	8	19.5		27	65.8	14	34.2
Place of stay of the child who does not attend daycare^† † Information was not obtained for the entire sample.					0.085					0.455
Parents' house	188	71.5	75	28.5		202	76.8	61	23.2
Another place	15	55.6	12	44.4		19	70.4	8	29.6
Primary caregiver of the child who does not attend daycare^† † Information was not obtained for the entire sample.					0.189					0.115
Mother	185	70.9	76	29.1		203	77.8	58	22.2
Others	21	60.0	14	40.0		23	65.7	12	34.3)
Daily time (hours) of television exposure (>1 year of age)^† † Information was not obtained for the entire sample.					0.523					0.008
< 1	20	64.5	11	35.5		23	74.2	8	25.8
≥1	65	70.6	27	29.4		43	46.7	49	53.3

Aspects	Child development domains
	Social				P ^* * Chi-square test;	Psychic				P ^* * Chi-square test;
	Presence of all milestones		Absence of one or more milestones			Presence of all milestones		Absence of one or more milestones
	N	%	N	%		N	%	N	%
	256	76.9	77	23.1		271	81.4	62	18.6
Age (months)					<0.001					<0.001
< 12	179	88.6	23	11.4		185	92.0	16	8.0
12 ├ 24	42	53.8	36	46.2		55	70.5	23	29.5
≥ 24	35	66.0	18	34.0		31	57.4	23	42.6
Sex					0.982					0.558
Male	140	76.9	42	23.1		151	82.5	32	17.5
Female	116	76.8	35	23.2		120	80.0	30	20.0
Well-child care at the health center^† † Information was not obtained for the entire sample.					0.200					0.002
Yes	223	76.6	68	23.4		241	82.8	50	17.2
No	17	65.4	9	34.6		15	57.7	11	42.3
Child attendance at daycare^† † Information was not obtained for the entire sample.					0.841					0.316
No attendance	223	76.6	68	23.4)		239	82.1	52	17.9
Attendance	32	78.1	9	21.9)		31	75.6	10	24.4
Place of stay of the child who does not attend daycare^† † Information was not obtained for the entire sample.					0.313					0.006
Parents' house	205	78.0	58	22.0		221	84.4	41	15.6
Another place	18	69.2	8	30.8		17	63.0	10	37.0
Primary caregiver of the child who does not attend daycare^† † Information was not obtained for the entire sample.					0.189					0.027
Mother	203	77.8	55	22.2		218	83.9	42	16.1
Others	23	67.6	11	32.4		24	68.6	11	31.4
Daily time (hours) of television exposure (>1 year of age)^† † Information was not obtained for the entire sample.					0.012					0.637
< 1	24	77.4	7	22.6		21	67.7	10	32.3
≥1	47	51.6	44	48.4		58	63.0	34	37.0

Aspects	Absence GCD		Bivariate		Final model^* * Adjusted model for maternal education;		p ^† † Chi-square test;
Aspects	N	%	OR_crude	CI95%	OR_Adjusted^* * Adjusted model for maternal education;	CI95%	p ^† † Chi-square test;
Age (months)							<0.001
< 12	89	44.1	1.0	-	1.0	-
12 ├ 24	43	55.1	1.6	0.9-2.6	1.7	0.9-3.1
≥ 24	42	77.8	4.4	2.2-8.9	4.4	2.0-9.9
Sex							0.067
Male	87	47.5	1.0	-	1.0	-
Female	87	57.6	1.5	1.0-2.3	1.3	0.8-2.1
Well-child careat the health center^‡ ‡ Information was not obtained for the entire sample; CI95%=confidence interval of 95; OR=odds ratio; GCD= general child development.							0.215
Yes	154	52.7	1.0	-
No	17	65.4	1.7	0.7-3.9
Child attendance at daycare^‡ ‡ Information was not obtained for the entire sample; CI95%=confidence interval of 95; OR=odds ratio; GCD= general child development.							0.635
No attendance	154	52.7	1.0	-
Attendance	20	48.8	0.8	0.4-1.6
Place of stay of the child who does not attend daycare^‡ ‡ Information was not obtained for the entire sample; CI95%=confidence interval of 95; OR=odds ratio; GCD= general child development.							0.001
Parent's house	128	48.7	1.0	-	1.0	-
Another place	22	81.5	4.6	1.7-12.6	3.7	1.3-10.5
Primary caregiver of the child who does not attend daycare^‡ ‡ Information was not obtained for the entire sample; CI95%=confidence interval of 95; OR=odds ratio; GCD= general child development.							0.005
Mother	128	49.0	1.0	-
Others	26	74.3	3.0	1.3-6.6

[1] E-mail: katherine.solis22@usp.br

Brasil

Brasil

Developmental surveillance in primary health care: absence of child development milestones and associated factors

Abstract

Objectives:

Methods:

Results:

Conclusions: