Abstract
To assess inpatient mortality rate of very-low-birth-weight neonates, their clinical progression and factors associated with mortality. Longitudinal study including 360 neonates weighing 500-1500 g who were born in Londrina, Southern Brazil, from January 1, 2002 to June 30, 2004. Data were collected through interviews with the mothers and from medical records and follow-up of neonates during hospitalization. Chi-square test was used to determine the association between variables. Statistically significant variables were selected to the logistic regression model and the level of significance adopted was 5%. Mortality rate was 32.5%. In bivariate analysis, the following variables were associated with death: no prenatal use of corticosteroids; no hypertension/preeclampsia; labor; vaginal delivery; non-cephalic presentation; Apgar scores <or= 3 at the first and fifth minutes; Clinical Risk Index for Babies score > 5; male sex; weight < or=750 g; gestational age < 28 weeks; resuscitation procedures in the delivery room; respiratory distress syndrome; pneumothorax; intracranial hemorrhage; and mechanical ventilation. In the logistic regression, the following variables were still considered risk factors: low income; no prenatal use of corticosteroids; no use of continuous positive airway pressure. Despite technology advances, very-low-birth-weight neonates mortality is high in Brazil compared with developed countries. Prenatal use of corticosteroids should be encouraged to reduce morbidity and mortality of very-low-birth-weight neonates.
Highlights
The following variables were associated with death: no prenatal use of corticosteroids; no hypertension/preeclampsia; labor; vaginal delivery; non-cephalic presentation; Apgar scores ≤ 3 at the first and fifth minutes; Clinical Risk Index for Babies score > 5; male sex; weight ≤ 750 g; gestational age < 28 weeks; resuscitation procedures in the delivery room; respiratory distress syndrome; pneumothorax; intracranial hemorrhage; and mechanical ventilation
Despite technology advances, very-low-birth-weight neonates mortality is high in Brazil compared with developed countries
A ventilação pulmonar mecânica (VPM) foi relatada como fator importante associado ao risco de morte em outras pesquisas.[6,15] Essa associação pode estar sendo confundida, pois no presente estudo todos os recém-nascidos que foram à óbito na unidade neonatal receberam ventilação mecânica em algum momento, com exceção das crianças que foram a óbito na sala de parto, motivo pelo qual foi excluída da análise multivariada
Summary
Longitudinal study including 360 neonates weighing 500–1500 g who were born in Londrina, Southern Brazil, from January 1, 2002 to June 30, 2004. Data were collected through interviews with the mothers and from medical records and follow-up of neonates during hospitalization. Chi-square test was used to determine the association between variables. Significant variables were selected to the logistic regression model and the level of significance adopted was 5%
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