Interação mãe-filho e funcionalidade de lactentes com risco para atraso no desenvolvimento no primeiro ano de vida: telecuidado em tempos de pandemia da COVID-19

Abstract

Abstract: Contextual factors act directly on health and functionality conditions, especially in the current pandemic scenario caused by coronavirus 2 (COVID-19), since it has affected quality of life and personal interactions. Despite this, no studies were found that have verified barriers and facilitators for the quality of mother-child interaction during the current scenario. Objectives: 1) to identify contextual factors that may contribute to the quality of mother-child interaction in infants with and without biological risk, during social distancing in the COVID-19 pandemic; 2) to compare mother-child interaction between sexes and between age groups (3-6 months and 7-12 months). Methods: Infants aged three to 12 months, 42 with biological risk and 33 without biological risk, and their mothers were included. The assessments were performed from home videos recorded asynchronously, and mother-child interaction behaviors were based on the Parent-Child Early Relational Assessment (PCERA) instrument. Forms were sent to characterize the participants; about social distancing due to COVID-19; maternal depression and anxiety (DASS-21 scale); quality and quantity of resources in the home environment (Affordances in the Home Environment for Motor Development – ​​infant scale AHEMD-IS); Socioeconomic level, through the Brazilian Association of Research Companies (ABEP). The Stepwise multiple regression model was used to verify the association of contextual factors in the outcome variables. Shapiro-wilk test was used to verify data distribution and the Mann-Whitney test to compare the interaction between groups, sexes and age groups. The significance level adopted was 5%. Results: There was a significant difference in maternal interaction between the age groups of the risk group, mothers interact better with infants younger than six months (p=0.04) and in the interaction between the risk and non-biological risk groups, in which the group without biological risk had higher interaction scores for all dimensions, mother, child and dyad (p=0.001). In addition, there was no difference in mother-child interaction and dyad between the sexes for both groups. For the mother interaction in the group at risk, only the variable age of the infant younger than 6 months was significant (β= −8,426; p=0.0461), while in the group without biological risk it was maternal schooling (β=5,861; p =0.0352) and the greater variety of AHEMD-IS stimulation (β=0.997; p=0.0112). For the interaction of the child in the risk group, only the breastfeeding variable was significant (β=10,996; p=0.0282), while for the group without biological risk, it was breastfeeding (β=9.168; p=0.0115), age over 6 months (β=7.961; p=0.0161) and maternal education level (β=6.259; p=0.0462). For the dyad interaction in the risk group, the significant variables were age younger than 6 months (β=−53,225; p=0.0019), older age in days of infants (β=23,196; p=0.0233) , male infants (β=23,196; p=0.0110) and older maternal age (β=2,077; p=0.0225), while breastfeeding (β=13,416; p=0) .0062), maternal education level (β=10,408; p=0.0167), amount of fine motor toys (β=1,942; p=0,0392) and amount of people interacting with the infant during the pandemic (β =3,589; p=0.0004). Conclusion: Contextual factors are only relevant to mother-child interaction when analyzed together. Despite the changes that the COVID-19 pandemic can cause, most families in both groups showed no environmental damage. Furthermore, it is seen that the quality of interaction is lower in the risk group, in which mothers interact better with younger infants.