Comprehensive health care for children in the Unified Health System of Botucatu/SP: morbidity of pre-school and school children born with low birth weight from 2004 to 2008

Abstract

The low birth weight newborn has been the objective of many studies due to its important participation in infant's mortality and morbidity, besides the risks to its growth and development. Nowadays, the premature and low birth weight newborn have more chance to survive. The attendance and the opportune intervention, functions of the different levels of health assistance in its integrality, seek to offer the newborn child the conditions to its global development, as adequate as it can be, therefore modifying its prognosis. For the group with less than 1500 grams of weight, the knowledge about a bigger probability of changes in its growth and development motivated the construction of specific protocols for their accompaniment and interventions. However, for the children between 1500 e 2500 grams of weight - a more heterogeneous group of causes and alterations - there's only little definition about evaluation instruments, as well as for accompaniment methods in health and in school. General purpose: To describe the frequency of morbidity in pre-scholar and scholar children, low birth weight newborns between 2004 and 2008, in the city of Botucatu/SP / Brazil. Specific purposes:*To describe the frequency of chronic diseases and disabilities (motor, sensory, cognitive and in the speech) in children born with low birth weight.*To describe the care and follow-up of the children included in this study, in the Public Health Units in Botucatu city - Basic Units of the primary health care system and in the Outpatient Clinics in the Clinics Hospital. *To compare the results of these parameters above in low birth weight newborns with a group of non-low birth weight children, born in the same period (case and control groups).Method: A case-control study, approved in the Ethics Committee. After the consent in participating the Project, the first and second steps will take place simultaneously for the children in both groups (Case - low birth weight newborn, and Control - not low birth weight). A total of 860 infants born with low weight in the study period, in a randomized sample of 104 infants in the case and control groups will be analysed. In the first step, from the SINASC data - The Birth Certificate, the following information will be collected: maternal age at the time of the child's birth; maternal schooling (complete years of study); number of children in previous pregnancies, live born and stillborn; neighborhood or district of residence; gestation length (measured in weeks) grouped in pre-term pregnancy (shorter than 37 complete weeks), term pregnancy (between 37 and 41 complete weeks) and post-term pregnancy (longer than 42 complete weeks); type of pregnancy - single, twins, triplets; type of delivery - normal, cesarean, with forceps; number of prenatal queries; newborn gender; Apgar score in the fifth minute; birth weight; presence of congenital malformations and/or chromosomal abnormalities. In the second step, interviews with representatives, through a questionnaire to choice or dichotomous, about theirs antecedents and personal diseases or disabilities, in the case and control group. The statistical program SAS version 9.2 software will be used. The present study intends to evaluate the growth conditions of this group of low birth weight newborn, in comparison to the control group, and to assist the municipal management of the Basic Attention in Pediatrics, in the Public Health System, in the definition of protocols and required procedures to improve the attendance of these children, specifically those between 1500 and 2500 grams of weight, in order to avoid deviations in their growth as well as to potentiate health actions for this population group.