Perfil epidemiológico da prematuridade e comorbidades associadas em recém-nascidos prematuros de muito baixo peso

Abstract

Objective: To describe the major epidemiological features of prematurity, risk factors, prevalence of comorbidities, death and survival rates in very low birth weight newborns. Methods: Transversal study with rectrospective data collection from medical charts of 616 premature and very low birth weight newborns admitted to Complexo Hospital de Clínicas da UFPR (CHC-UFPR) between August 2008 and August 2018. It was studied comorbidities prevalence, survival rate and factors related to mortality. For all statistical tests, it was considered a 5% level of significance. Results: The average gestational age (GA) was 28.2 ± 2.9 weeks and the average birth weight (BW) was 997.4 ± 279.9 grams. The population with GA < 28 weeks (42.5%) had a greater need for neonatal resuscitation and ventilatory support and a higher prevalence of the following diseases: respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary hypertension, pulmonary hemorrhage, peri-intraventricular hemorrhage (PIVH), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) and early-onset neonatal sepsis. The main comorbidities associated with an increased risk of death were (p <0.05): RDS (OR: 4,04), pulmonary hemorrhage (OR: 5,21) and PIVH (OR: 3,32). The reduction in survival rate was associated with lower values ??of GA and BW, as well as the presence of respiratory and neurological comorbidities. Conclusions: Extremely premature newborns have a higher prevalence of comorbidities and neonatal complications. Low birth weight, morbidities of the respiratory and neurological systems were the main factors associated with increased mortality.