Does Gestational Age of Preterm Infants Influence the Participation in Activities of Daily Living?

Introduction: It is known that the grounded perceptual-motor experience within cultural and social contexts shapes infants’ cognition and early behaviors, such as object interaction, sitting, and locomotion.

Global development is widely facilitated by these experiences. Infants born preterm (before 37 weeks of gestation) may explore their environments poorly, thus being at risk for global developmental impairments. We aimed to investigate the correlation between the levels of achievement of participation in daily activities and social roles and prematurity level.

Materials and Methods: This is a cross-sectional study. Twenty-four preterm infants (17 boys and 7 girls) were included, equally divided into three groups (extreme =  < 30 weeks, moderate = 31–34 weeks, and borderline prematurity = 35–37 weeks’ gestational age), ages ranging from 3 to 11 months. Their caregivers were interviewed through the Assessment of Life Habits - Brazilian version (LIFE-H_BR). Sixty-one items in 11 domains (nutrition, fitness, personal care, communication, housing, mobility, responsibilities, interpersonal relations, community life, education, and recreation) were tested, regarding the level of achievement and assistance required (0—not accomplished/not applicable, 1—performs with human assistance, 2—performs with adaptation, and 3—performs without assistance/adaptation). Spearman’s correlation test was applied with a significance level of 0.05.

Results: In seven LIFE-H_BR items, there was a significant, positive correlation, indicating that the extreme prematurity group presented more difficulty in participating these items. These items are related to nutrition (item 6; r = 0.626; p = 0.001); fitness (item 8; r = 0.414; p = 0.044); housing (item 29; r = 0.562; p = 0.004; item 30; r = 0.471; p = 0.020; and item 31; r = 0.411; p = 0.046), community life (item 47; r = 0.518; p = 0.010), and recreation domains (item 58; r = 0.449, p = 0.028). In other words, extreme preterm infants presented lower scores for domains related to: eating with utensils or hands; getting in and out of bed; entering and exiting the home; moving around in one floor or from one floor to another in the home; participating in religious activities; and practicing artistic activities, while moderate and borderline preterm infants were able to accomplish these items ([Fig. 1]).

Conclusion: Extreme preterm infants presented lower scores compared with moderate and borderline for some domains due to less participation in daily activities and social roles, indicating decreased functionality. Thus, it is important that health care providers target activities and participation in therapeutic planning, rehabilitation, and in early interventions because this may be feasible and effective at advancing a range of abilities across developmental domains.

Fig. 1 Levels of achievement of participation in daily activities and social roles and prematurity level.