Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers
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Data
2008-07-01
Autores
Branco de Almeida, Maria Fernanda
Guinsburg, Ruth
Martinez, Francisco Eulogio
Procianoy, Renato S.
Leone, Clea Rodrigues
Marba, Sergio Tadeu Martins
Rugolo, Ligia Maria Suppo de Souza [UNESP]
Luz, Jorge Hecker
de Andrade Lopes, Jose Maria
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Pediatria
Resumo
Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression.Results: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth.Conclusion: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.
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Palavras-chave
neonatal mortality, infant, newborn, infant, preterm, infant, very low birth weight
Como citar
Jornal de Pediatria. Rio de Janeiro, Rj: Soc Brasil Pediatria, v. 84, n. 4, p. 300-307, 2008.