Mãe adolescente e o recém-nascido pré-termo e de baixo peso: Estudo sobre cuidado, vínculo e desenvolvimento no ambiente hospitalar

Abstract

Introduction: fifteen million babies are born prematurely worldwide each year, most of them with a history of low birth weight, which require technological support and specialized care to maintain their clinical stability and survival. In these terms, a considerable percentage of these births come from women still in their adolescence, who also require specialized care and a family support network to ensure safe and effective pre, peri and postnatal care. Considering the particularities linked to the two contexts, this study glimpses how the aspects related to the neurobehavioral development of babies are processed, what are the care needs and what permeates the relationship that is established between mother and baby still in the hospital environment, considering the need to hospitalization of the baby due to its clinical condition and the processes that involve the beginning of motherhood when it is still in adolescence. Objective: To analyze the relationship between the bond/attachment between adolescent mother and baby, maternal care and the neurobehavioral development of preterm and low birth weight babies in the environment of a neonatal unit. Method: this is a cross-sectional, exploratory, descriptive research, with a quantitative-qualitative approach. The research was developed in a maternal and child hospital in the north of Brazil, a reference in Kangaroo Method, specifically in the Kangaroo Unit - UCINCa. Thirty-one dyads, adolescent mothers and their respective preterm and low birth weight babies, participated. The following instruments were applied: Socio-Demographic and Clinical data sheet; Postnatal Attachment Scale, Hammersmith Neonatal Neurological Examination, and semi-structured interview. Data were analyzed using Pearson's Correlation Test and ANOVA, organized by tables containing frequencies and means (significance level α = 0.05 or 5%;); for lexical analysis of the interviews we used the Iramutec Software, version 0.7 alpha2, through the Descending Hierarchical Classification. Results: the quantitative data indicated a good maternal attachment response in MAPS, a neuroevolutionary pattern appropriate to the corrected gestational age of newborns; significant correlations between the pattern of maternal attachment to sociodemographic data, especially those related to the social support network and maternal education; however, low correlation between neurological development and attachment pattern. Qualitative data showed significant involvement of the adolescent mother in the monitoring and care provided to her baby, rescuing her maternal role during the follow-up of her baby. Conclusion: this research demonstrated that the maternal and clinical variables of the baby are directly related to the formation of the bond between mother and baby; the pattern of neurobehavioral development continues to evolve neurologically independent of maternal and infant variables; maternal care is established through the mother's involvement in the routine of the neonatal unit; and adolescent motherhood showed similarity about bonding and care when compared to studies carried out with adult mothers. The social support network has a direct influence on the emotional aspects of the teenage mother, thus reinforcing the importance of promoting family involvement in care, which interferes with the quality of life of the mother and baby after hospital discharge. Family support policies, prevention of teenage pregnancy and efficient prenatal care directed to this clientele, are essential subsidies for a better prognosis of the baby's neuropsychomotor development, as well as minimizing the risks of maternal and neonatal morbidity and mortality and promoting greater bonding. between mother and baby.