High-risk Babies Research Articles

Impact of an mHealth intervention on parents' emotional health and on the neurodevelopment of high-risk infants.

We assess the prenatal and postnatal effect of the High-Risk Pregnancy and Baby Parenting programme, which is complemented with two mHealth (app-based) resources. The GLM Repeated Measures Model technique was used to explore differences in the emotional health of the participants and in their infants' neurodevelopment, comparing programme versus usual care groups, composed of 150 and 195 participants, respectively. The mothers presented lower levels of depression (mean difference 1.74, p = 0.04, 95% CI 0.07, 3.40) and higher levels of resilience (mean difference 4.09, p = 0.004, 95% CI 1.40, 6.78). For the fathers, positive effects on resilience were recorded (p < 0.001). A positive treatment effect was perceived in the infants' cognitive (p = 0.014), language (p < 0.001) and motor (p = 0.006) development. These findings suggest application of the programme can benefit maternal emotional health and infant neurodevelopment. M-Health technology could make this programme more accessible.

The Impact of Parent-Based Support Programs on Neurodevelopmental Prognosis: Second-Year Results from a Newly Established Neurodevelopmental Follow-Up Unit in a Tertiary Hospital.

This study aims to assess the neurodevelopmental progress of high-risk infants 2 years post implementation of the Neurodevelopmental Follow-Up Unit (NFU) program at our hospital and explore implementation challenges for insights. Infants were assessed using the Hammersmith Infant Neurological Examination (HINE), The Alberta Infant Motor Scale (AIMS), and Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). A multidisciplinary team provided comprehensive parent education covering neurologic cues, postural advice, and developmental instructions in accordance with the children's assessment findings. In addition, a pediatric physical therapist provided motor development training emphasizing age-appropriate milestones and functional independence, while child development specialists addressed delays identified through BSID-III assessments. A total of 121 high-risk babies were enrolled during a 2-year period. Results revealed that 9 infants exhibited suboptimal HINE scores at 3-4 months, with only 2 maintaining suboptimal scores at 12-15 months. Similarly, 2 infants with suboptimal AIMS scores at 3-4 months reached normal values at 12-15 months. Comparable improvements were observed in BSID-III scores. While no correlation between HINE and AIMS scores was found at the 3-4-month mark, a significant correlation emerged between AIMS and HINE scores at 6-9 months (r = 0.643, P < .001) and 12-15 months (r = 0.820, P < .001). Encouraging early family education alongside regular monitoring of high-risk newborns appears to have a positive impact on their motor and cognitive development. Consideration of clinical recommendations, such as tailored interventions and periodic assessments, may contribute to optimizing developmental outcomes.

Positional Regulation, Sucking Reflex and Incidence When Given Nutrition Through OGT in High-Risk Infants with Low Birth Weight Infants in the Nicu Room: A Case Study of Waled Hospital

High-risk babies are babies born at 32 – 36 weeks of gestation/prematurely, babies whose mothers suffer from Diabetes Mellitus, babies with a history of apnea, babies with seizures, sepsis, asphyxia, babies with bleeding disorders or breathing problems. Problems that often arise in cases of LBW babies include unstable body temperature, breathing problems, digestive and nutritional disorders, liver immaturity, anaemia, intraventricular bleeding, seizures, infections, hypoglycemia, hyperglycemia and hypocalcemia. This study aims to provide nursing care to babies at high risk in the Nicu Room at Waled Hospital, Cirebon Regency, on 27 December 2023. Examination of the sucking reflex is recommended as a screening that shows intact motor neuron function in neonates. The sucking reflex is well-developed in normal babies and is coordinated with breathing. Inhibition of the sucking reflex in the first hours of life will affect the ability to suck at the beginning of life and will directly hinder the nutritional intake received by the baby. Arranging sleeping positions for newborn babies is the role of the neonatal nurse in providing routine daily care. Positioning, especially for premature babies, is not easy. Positioning errors can result in changes in physiological status (increased respiratory rate, pulse frequency, and decreased oxygen saturation), disturbed comfort and quality of sleep, drinking intolerance, hip joint deformity, and bleeding in the brain. The issues affecting all three clients have not been resolved. However, interventions such as positioning, assessing sucking reflexes in high-risk babies, and providing nutrition through OGT are ongoing, with efforts to set the supine sleep position during enteral nutrition. While the problems faced by the high-risk infants in this study are not yet resolved, ongoing nursing interventions are crucial in managing their care. Continued attention to proper positioning, monitoring of sucking reflexes, and nutritional support through OGT is vital for improving the health outcomes of these vulnerable infants.

A study of asymptpmatic hypoglycemia in at risk newborn babies admitted at a tertiary care hospital

: Babies often have blood glucose levels that are 70% of their mothers at birth. Within an hour, it reaches its lowest point, which can be as low as 20 to 25 mg/dl. All healthy newborns experience this low point and have lower than average blood glucose levels. These are just temporary, and they gradually increase in the first few days of a newborn's life. : To determine the proportion of asymptomatic hypoglycemia in at risk newborn babies. To study plasma sugar level at various time, point during first 48hr of life and the effect of risk factor associated with asymptomatic hypoglycemia. : A Hospital-based longitudinal observational study was conducted among 303 patients at Department of Pediatrics of tertiary care Hospital during June 2021 – July 2021. : Total 159 were males and 154 were females. Among the study participants, 203(83%) cases were from Urban area, while 50(17%) were from Rural area. No. of 114(37.6%) babies had asymptomatic hypoglycemia, identified by routine screening. In total various risk factors was found in which among 29% cases had LGA, 41% had preterm and 30% had weight less than 2 kg. : Screening of at risk newborn helps in the early detection of asymptomatic hypoglycemia which will help in the prevention of adverse neurodevelopmental outcome. Routine screening helped to decrease morbidity and mortality due to hypoglycemia. The first 24 hours of life is a crucial part, at - risk babies are more prone to hypoglycemia hence routine screening is recommended in high-risk babies.

Can prophylactic oral dextrose solution prevent hypoglycemia in high risk newborns?

Prophylactic oral dextrose gel recommended to prevent hypoglycaemia in high risk babies is not readily available and affordable. This study was therefore conducted to find out if oral dextrose solution decreases the incidence of hypoglycaemia in high risk neonates. This study included 186 high risk newborns. Oral 10% dextrose 2ml/kg was given at 30 minutes, 2, 6 and 12 hours of life, along with direct breastfeeding. Capillary blood glucose measurement was monitored at 2, 6, 12, 24, 48 and 72 hours of life. Low blood sugar levels were confirmed by simultaneous venous blood sampling. Statistical tests used were chi square for proportions and ANOVA for means. Of the 186 high risk babies maximum babies were small for gestational age (n = 68, 36.5%). Among the high risk babies, 7 (3.7%) developed hypoglycaemia. All were asymptomatic. A higher proportion of hypoglycaemia was seen IUGR babies (n = 2/9, 22.2%) and in those delivered by caesarean section (n =3/71, 4.2%). Compared to the incidence of hypoglycaemia (7.2%) in the historical control group the incidence of hypoglycaemia (3.7%) in interventional group was lower though statistically not significant (p=NS). There is a decrease in the incidence of hypoglycemia in high-risk infants given prophylactic oral dextrose solution. However, this trend was not statistically significant.

CNN-Based Pattern Classifiers for Precise Identification of Perinatal EEG Biomarkers of Brain Injury in Preterm Neonates

Electroencephalographic (EEG) monitoring is important for the diagnosis of hypoxic-ischemic (HI) brain injury in high-risk preterm infants. EEG monitoring is limited by the reliance on expert clinical observation. However, high-risk preterm infants often do not present observable symptoms due to their frailty. Thus, there is an urgent need to find better ways to automatically quantify changes in the EEG these high-risk babies. This article is a first step towards this goal. This innovative study demonstrates the effectiveness of deep Convolutional Neural Networks (CNN) pattern classifiers, trained on spectrally-detailed Wavelet Scalograms (WS) images derived from neonatal EEG sharp waves—a potential translational HI biomarker, at birth. The WS-CNN classifiers exhibit outstanding performance in identifying HI sharp waves within an exclusive clinical EEG recordings dataset of preterm infants immediately after birth. The work has impact as it demonstrates exceptional high accuracy of 99.34 ± 0.51% cross-validated across 13,624 EEG patterns over 48 h raw EEG at low 256 Hz clinical sampling rates. Furthermore, the WS-CNN pattern classifier is able to accurately identify the sharp-waves within the most critical first hours of birth (n = 8, 4:36 ± 1:09 h), regardless of potential morphological changes influenced by different treatments/drugs or the evolutionary ‘timing effects’ of the injury. This underscores its reliability as a tool for the identification and quantification of clinical EEG sharp-wave biomarkers at bedside.

Respiratory Distress Syndrome (RDS) in Newborns with Hypoxic-Ischemic Encephalopathy (HIE).

Respiratory distress syndrome (RDS) and hypoxic-ischemic encephalopathy (HIE) are frequent causes of death and disability in neonates. This study included newborns between January 2021 and July 2022 at the University Clinic for Gynecology and Obstetrics, Skopje. Up to date criteria for HIE/RDS for term and for preterm infants as well for the severity of HIE/RDS were used in a comprehensive analysis of cranial ultrasonography, neurological status, neonatal infections, Apgar score, bradycardia and hypotension, X-ray of the lungs, FiO2, acid-base status, assisted ventilation and use of surfactant. Three groups were created: HIE with RDS (42 babies), HIE without RDS (30 babies) and RDS without HIE in 38 neonates. All newborns with severe (third) degree of HIE died. Intracranial bleeding was found in 35.7% in the first group and 30% in the second group, and in the third group in 53.3%. The need for surfactant in the HIE group with RDS is 59.5%, and in the RDS group without HIE 84.2%. DIC associated with sepsis was found in 13.1-50% in those groups. In newborns with HIE and bradycardia, the probability of having RDS was on average 3.2 times higher than in those without bradycardia. The application of the surfactant significantly improved the pH, pO2, pCO2, BE and chest X-ray in children with RDS. An Apgar score less than 6 at the fifth minute increases the risk of RDS by 3 times. The metabolic acidosis in the first 24 hours increases the risk of death by 23.6 times. The combination of HIE/ RDS significantly worsens the disease outcome. The use of scoring systems improved the early detection of high risk babies and initiation of early treatment increased the chances for survival without disabilities.

Support for the Right to Life among Neonatal Intensive Care Nurses in Korea.

The increase of high-risk newborns due to societal changes has presented neonatal intensive care unit nurses with more ethical challenges and heightened their perception of neonatal palliative care. Therefore, this study was a descriptive survey exploring the perceptions of neonatal intensive care unit nurse regarding biomedical ethics and neonatal palliative care in neonatal intensive care units. The research participants were 97 neonatal intensive care unit nurses who had been directly involved with end-of-life care for high-risk babies. Data were collected from November to December 2021 through an online survey. The Korean version of Neonatal Palliative Care Attitude Scale and the tool of biomedical ethics were used. The collected data were analyzed using the T-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. The mean score for perception of biomedical ethics in neonatal intensive care unit nurses was 2.89 of 4, and that of neonatal palliative care in neonatal intensive care unit nurses was 3.10 of 5. Existence of a protocol of neonatal palliative care, the experience of patients dying, and the right to life of neonates were factors influencing the perception of neonatal palliative care. The explanatory power was 12.5%. The data support the importance of guidelines regarding systematic neonatal palliative care. Also, developing programs for sharing and supporting experiences of patients dying among colleagues and persistent education about the right to life of neonates for neonatal intensive care unit nurses can improve perception of neonatal palliative care.

OVERVIEW OF PATIENTS SCREENED FOR AND DIAGNOSED WITH ROP IN PEDIATRIC OPHTHALMOLOGY OUTPATIENT CLINIC BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC

Introduction &amp; Objectives : The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, leading to significant changes in the delivery of medical services. Non-urgent ophthalmology visits were canceled. However, premature infants at risk of retinopathy of prematurity (ROP) require timely and in-person care to prevent vision loss. This study aims to report on the high-risk babies screened and diagnosed with ROP before, during, and after the COVID-19 pandemic&#x0D; Methods : This is a descriptive study conducted on premature infants who visited the pediatric ophthalmology outpatient clinic at Cipto Mangunkusumo Hospital Jakarta between January 2019 and December 2022. Data was collected using medical records and presented using tables and charts&#x0D; Results : A total of 368 babies were screened for ROP in 2019, and 75% were diagnosed with ROP. During the lockdown in 2020, the number of babies screened for ROP decreased to 286, and the incidence of ROP was 38.5%. In 2021 and 2022, ROP screening increased to 458 and 515 babies per year, respectively. After the COVID-19 pandemic subsided, ROP screenings increased significantly from 2020 to 2021. The number of babies screened in 2021 and 2022 was similar, but the incidence of ROP decreased from 45.4% in 2021 to 20.3% in 2022&#x0D; Conclusion : This study highlights the impact of the COVID-19 pandemic on ROP screening and diagnosis in a pediatric ophthalmology outpatient clinic. After the COVID-19 pandemic, the number of babies screened for ROP increased due to the end of the lockdown

Scoping review of interventions to improve continuity of postdischarge care for newborns in LMICs

IntroductionNeonatal mortality remains significant in low-income and middle-income countries (LMICs) with in-hospital mortality rates similar to those following discharge from healthcare facilities. Care continuity interventions have been suggested as a...

Editorial

Editorial

Cerebral visual impairment and effect of phase-wise stimulation strategies-An interim analysis.

Cerebral visual impairment (CVI) is an overarching term, defined as a brain-based visual impairment with onset in childhood, unexplained by an ocular disorder and associated with unique visual and behavioral characteristics. Good vision and awareness of visual function in a child are highly essential as neuroplasticity is maximum in the first three years of life and response to intervention is utmost in this period. Awareness is lacking regarding CVI, and the diagnosis is largely missed. This can be easily addressed if a structured approach is employed. This study aims to evaluate the etiology and radiological correlation with the severity of CVI and outcome after structured intervention in children with CVI. Prospective-interventional study. Children attending the Child Development Centre (CDC) of a tertiary care hospital in North Karnataka and diagnosed with CVI in the age group of six months to 12 years and meeting the sampling criteria were screened and enrolled consecutively after obtaining parental consent/assent. Statistical analysis used is nonparametric test with SPSS software. Age showed a significant association with the phase of CVI. Perinatal insult was associated significantly with the severity of CVI. Magnetic resonance imaging (MRI) findings did not hamper the recovery of CVI. Enrolment in early intervention programs tailored according to child's specific needs should be encouraged, with stress on ophthalmic screening of preterm and high-risk babies with perinatal hypoxia and history of convulsions, as early as six months.

Factors to improve the quality of comprehensive emergency obstetric and newborn care

This study aimed to explore healthcare team members’ perspectives towards the factors that can contribute to the quality improvement of comprehensive emergency obstetric and neonatal care (CEmONC) services at a tertiary hospital. This qualitative descriptive study used convenience sampling to collect the sample. The inclusion criteria were the health workers who have worked for at least one year, in which a total of 119 participants took part in this study. The data were obtained from an online questionnaire, and the collected data were then analyzed with qualitative thematic analysis. This study revealed that three key aspects affecting the success of CEmONC services: i) health human resources (high-quality healthcare workers, in adequate proportion, with excellent teamwork, and commitment to being on time); ii) facilities and infrastructure (the availability of the intensive care unit and 24-hour laboratory, and the access to the obstetric/neonatal ward), and iii) the hospital service system (well-integrated external referral system and internal consultation). As the highest referral healthcare center, hospital managers should monitor and evaluate these three factors periodically to ensure that high-risk mothers and babies can acquire appropriate subspecialty care in the hospital and further can reduce maternal and neonatal mortality rates.

Effects of a Noncontact Visit Program in the NICU for the Prevention of COVID-19.

With the spread of COVID-19, neonatal intensive care units restricted visiting hours to prevent infection. As a result, mothers of high-risk newborns were restricted from making contact with their children. Various problems could be encountered for hospitalized children and mothers of high-risk newborns due to restrictions on visits in the neonatal intensive care unit. Therefore, during the pandemic, continuous nursing support for mothers of high-risk newborns was needed. In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 36 mothers of high-risk neonates (20 in the experimental group and 16 in the control group) in E University Hospital, D Metropolitan City, from July to September 2022. The experimental group received a 10 min program performed by a nurse from 7:00 p.m. to 9:00 p.m. three times per week. There were significant differences in nurses' support between the experimental and control groups (F = 25.594, p < 0.001), changes over time (F = 16.178, p < 0.001), and time-group interactions (F = 9.663, p = 0.003). It was interpreted that the real-time noncontact visitation program could transcend time and space for many mothers of high-risk newborn babies, who suffered psychologically due to restrictions and bans on visitations during the COVID-19 pandemic.

Knowledge and attitudes of breastfeeding mothers towards breast milk banking

Introduction: This research was conducted to determine the opinions of breastfeeding mothers regarding breast milk banking. The aim of this study was to investigate the attitudes of breastfeeding mothers towards breast milk banking and to determine the potential impact of education on increasing knowledge and awareness of breast milk donation. Methods: The study was carried out with 303 breastfeeding mothers who presented to the healthy child and general pediatrics clinics between April 15, 2020 and September 1, 2020, for various reasons. After a brief information session on breast milk banking, a 20-question survey was conducted face-to-face with the mothers. The questions related to breast milk banking in the survey were prepared according to the literature. The first part of the survey included demographic questions about the mothers, and the second part included questions about breast milk banking. Results: The mean age was found to be 32.6±5.9 years. 67.7% of the mothers had heard of breast milk banking before, while 73.6% did not know if there was a breast milk bank in Turkey. Additionally, 61.7% of the mothers had a positive view of donating breast milk, and 76.2% stated that they could give their milk to another baby if there was a need. As the education level of the mothers increased and the number of pregnancies exceeded three, the rates of those who considered donating breast milk and those who stated that they could use donor milk for their own children if necessary were found to be statistically significant (p &amp;lt;0.05). Conclusion: As the education levels and number of pregnancies of the participating mothers increased, the rates of those considering donating breast milk also increased. The most significant difference of our study compared to other similar studies is that, with the brief information provided to the mothers during the study, their knowledge and awareness increased, and they indicated that they could donate their milk to breast milk banks and use donor milk for their own children when necessary. Providing education to mothers about breast milk banks in our country can have a positive impact on establishing breast milk banks. In addition, it is believed that increasing women's education levels is important not only for their own babies but also for providing milk to all high-risk babies in the society. Keywords: Breast Feeding; Health Knowledge, Attitudes, Practice; Infant; Milk Banks; Human Milk

Current Trends in Antifungal Prophylaxis for High-Risk Neonates in Neonatal Intensive Care Units in India: A Nationwide Survey.

Background Prophylactic antifungals are often used in high-risk babies in neonatal intensive care units (NICUs) to reduce invasive fungal infections (IFIs). However, existing guidelines regarding prophylactic antifungal usage do not clearly define the high-risk population. This study aimed to assess the practices related to prophylactic antifungal use in NICUs in India. Methods For this cross-sectional study, an online structured questionnaire was completed by neonatologists who worked in level 3 NICUs in 12 states in India during the period June 2022 to August 2022. Results Data from 151 NICUs were analyzed. 71.7% of respondents were from private hospitals, and 28.3% were from government hospitals. Nearly one-fourth of the units (28.5%) used antifungal prophylaxis in all extremely low birth weight (ELBW) babies, while another one-fourth (25.8%) used a case-based approach. The remaining NICUs (45.7%) did not use prophylactic antifungals. Among the users, the preferred antifungal was fluconazole; 3 mg/kg and 6 mg/kg were the dosage regimens used. The commonly used interval for administering fluconazole was 72 hours (69.2% of units). The intravenous route was the preferred route of administration (84.1%). Factors that influenced the non-users were the low incidence of fungal infections in their NICUs and concern about the development of resistance. It was noted that the users felt strongly about the need for further recommendations from pediatric societies and more studies on the efficacy of antifungals. Conclusion There is considerable variation in the use of prophylactic antifungals across NICUs in India. Among the users, uniformity in the choice of antifungal and interval of administration was observed. Further recommendations from pediatric societies, including the definitions of neonates at-risk of fungal infections, are required to ensure consistency in practice and help clinicians decide whether or not to use prophylactic antifungals.

ASSOCIATED RISK FACTORS OF RETINOPATHY OF PREMATURITY AND ITS INCIDENCE IN A TERTIARY CARE TEACHING HOSPITAL OF EASTERN UTTAR PRADESH.

Purpose: To nd out incidence of ROP in high risk babies admitted to neonatal units and in whom who attended eye OPD, and to study common risk factors for its development.Methods: Detailed ophthalmic examination including history regarding risk factors was documented of all Infants of &lt; 35 weeks or &lt;1500 gram admitted to neonatal units of HIMS Safedabad , Barabanki or attended eye OPD during July 2021 to june2022 and they were followed till full maturation of retina. Results: Twenty four out of eighty nine {26.9%) children were diagnosed with ROP. Low gestational age and low birth weight were common risk factors among cases that developed ROP: association of ROP with oxygen therapy, blood transfusion, multiple pregnancy, phototherapy, hyperbilirubinemia, and preterm labour found insignicant. Conclusion: As survival of preterm infants increases because of better neonatal care and well equipped setup, ROP will become increasingly important potential cause of blindness. This emphasizes the critical need for ophthalmologic examination in premature infants, with immediate initiation of treatment when ROP is diagnosed.

Re-Evaluation of DDH Risk Factors in Helena Rehabilitation Center-Erbil, Kurdistan Region of Iraq

Purpose: Developmental dysplasia of the hip (DDH) comprises a spectrum of abnormalities from hip instability to frank dislocation, Hip ultrasonography prior to femoral head ossification, is recognized as an early diagnostic tool for DDH. It is safe and non-invasive procedure, keeping those babies less than 6 months of age away from radiation hazard. Subjects and Methods: From august 2021 until august 2022, we investigated 534 babies [1068 hips] by ultrasound depending on Graf method to identify DDH types. All included infants were in between 6 weeks- 6 months of age and referred due to have high risk factors. The data was analyzed by using the SPSS, version 28 and Chi- square test of association was used to compare the proportions. Results: On the bases of examining 534 babies [with high-risk groups] by ultrasound of hip, about 50.94 % of them were shown to have different types of DDH while 48.06% were normal, bilateral cases were &gt; unilateral cases and Lt. hip &gt;Rt. Hip were affected. Significant association was found between DDH family history (86%), breech presentation (52%)and swaddling (12%). Conclusions: It is crucial to establish the principle of selected screening programs for early detection of DDH in our society and to identify the incidence and associated risk factors for DDH in high-risk group babies between the ages of six weeks and six months in Erbil city of Kurdistan region-Iraq.

A Preliminary Study on Two-technology Neonatal Hearing Screening

Abstract Introduction: Newborn hearing screening is essential for the early identification of hearing loss, which can lead to timely intervention and improved outcomes for affected infants. Two commonly used screening methods are distortion product otoacoustic emissions (DPOAEs) and automated auditory brainstem response (AABR). While both methods are effective, there is still ongoing research to determine which method is more efficient and accurate. The aim is to compare the referral rates of DPOAE and AABR in neonatal hearing screening and to evaluate the efficacy of the two technologies in identifying hearing loss in high-risk and well-born neonates by adhering to the new 1–3-month timeline (Joint Committee on Infant Hearing, 2019). Methods: This was a prospective cross-sectional study conducted on 404 neonates (808 ears) in a multispecialty hospital in Tamil Nadu, India. Neonates with referral criteria for either DPOAE or AABR in the first step were rescreened immediately with the preferred technology. Obtained data were subjected to statistical analysis. Results: Among 404 (100%) neonates screened, 364 (90.14%) were well-born and 40 (9.90%) were high-risk babies. The total referral rate for DPOAE was 70 (8.6%) among which 54 (7.5%) were well-born babies and 16 (20%) were high-risk infants. The total referral rate in AABR was 68 (8.4%) among which 52 (7.2%) were well-born and 16 (20%) were high-risk infants. All the infants enrolled were screened by 1 month and no referrals were obtained for a detailed audiological diagnostic for reaching the 2-month benchmark and intervention by 3 months. Statistical analysis revealed no significant difference between the groups (P &gt; .01). Conclusion: AABR had similar referral rates with DPOAE in neonatal hearing screening. The two-technology screening protocol was effective in identifying hearing loss in high-risk and well-born neonates. The inclusion of AABR in the screening protocol proves utility in detecting retrocochlear pathologies such as auditory neuropathy spectrum disorder (ANSD).

Strengths and weaknesses in the high-risk baby care network

RESUMO Objetivo: caracterizar a Rede Cegonha na atenção à saúde ao bebê de alto risco, apontando seus principais desafios. Método: questionários foram aplicados com os responsáveis pelos bebês e com os profissionais de saúde da rede. Os dados foram analisados quantitativamente. Resultados: as variáveis estatisticamente relevantes foram: vínculo com a Unidade Básica de Saúde; conhecimento dos indivíduos sobre a equipe Núcleos de Apoio à Saúde da Família; ciência das equipes de Saúde da Família quanto ao diagnóstico de gravidez de risco e adesão ao pré-natal; via de comunicação do nascimento dos indivíduos; ciência quanto à necessidade de internação hospitalar, bem como sua duração; conhecimento sobre acompanhamento na Atenção Secundária à Saúde; e o desfecho do mesmo, apontando para uma dificuldade no eixo da coordenação e longitudinalidade dos serviços prestados na rede. Conclusão os maiores desafios estão na cobertura do território pelas equipes de estratégia de Saúde da Família, na ampliação de equipes e na solidificação das parcerias com as Instituições de Ensino Superior, garantindo uma formação profissional diferenciada.