Health And Child Development Risk Conditions: An Analysis Of High Risk Children In A Specialized Care Outpatient Clinic

Abstract

Objective: To describe the clinical and epidemiological characteristics of children seen at a high-risk outpatient clinic, report the reasons for referral to the service, the outcomes, and elucidate the importance of specialized care for children at risk provided by public health in Brazil. Method: A descriptive, quantitative, cross-sectional retrospective study that identified the clinical-epidemiological characteristics of children under 12 months of age who started care between January/2017 and December/2018 in a specialized outpatient clinic for high-risk children. Data were collected from electronic medical records and analyzed using Microsoft Excel 2013, while for statistical tests of association, calculation of the odds ratio and confidence interval (95%) the software RStudio (1.4.1103) was used. Results: Of the 246 children seen, 53.66% were male, 76.42% Caucasian, 33.62% premature, 54.73% had low/insufficient weight. At the first consultation 79.67% were less than six months old and 58.54% were eutrophic. The main reasons for referral were prematurity (26.89%), suspected congenital infection (15.53%) and nutritional/gastrointestinal disorders (14.77%). Syphilis stood out among congenital infections with 63.41%. As for the outcome, 62.28% were lost to follow-up, and the use of breast milk was a protective factor for this outcome (OR:0.49; CI:0.26-0.92; p=0.03). Conclusions: The reasons for referral to the high-risk outpatient clinic, evidenced in this study, point to the importance of preventing prematurity, controlling congenital infections, and actions to strengthen the practice of breastfeeding in children under 6 months of age, since it has proven to be a protective factor against loss to follow-up in specialized services.