Perfil epidemiológico dos prematuros tardios internados em uma unidade de terapia intensiva neonatal na Paraíba : um estudo retrospectivo.

Abstract

INTRODUCTION: The increasing number of premature births reflects on the occupation of neonatal intensive care beds throughout the country. Late preterm infants (LPI) are responsible for the largest share of this growth and are often treated in medical practice without the attention required for their physiological immaturity and for their greater risks of morbidity and mortality over term infants. The profile of this group of preterm infants admitted to Neonatal Intensive Care Units (NICU) lacks description in the literature, especially when it comes to neonatal care from a regional point of view. OBJECTIVES: To determine prenatal, delivery, neonatal and maternal characteristics of the LPI admitted to a neonatal NICU in Campina Grande-PB, when compared to other groups of different gestational ages. METHODS: This was a retrospective, cross-sectional observational study, in which the data was collected through a structured survey applied to the medical records of 322 newborns hospitalized in a NICU at the Instituto de Saúde Elpídio de Almeida (ISEA), a public maternity hospital in Campina Grande-PB during the year of 2016. It was used the software IBM SPSS version 20.0, from which descriptive data analysis was performed, followed by bivariate analysis for the main correlations established in the literature. Statistical significance was set at p <0.05. RESULTS: The LPI accounted for 23.5% of the admissions. More than two-thirds of the mothers came from Paraiba’s Agreste and Cariri regions. 44.4% of pregnant women had full prenatal care. Prenatal occurrences were associated with gestational age (GA) and affected all mothers of the LPI. Urinary tract infection was responsible for most, almost half of the mothers of the LPI. A correlation was found between cesarean section and late preterm birth. Most of the births were male and the female gender was more associated with prematurity. Sepsis was related to earlier preterm infants. A smaller apgar was more associated with the term ones, and the pelvic presentation was correlated with the LPI. Infants born at term needed more neonatal resuscitation compared to other groups. LPI and early preterm infants were similar in relation to respiratory morbidity. The supportive treatment was the same for all, but the HOOD and CPAP were more used in the LPI, the VMA on the earlier preterms. Hypoglycemia and jaundice correlated with GA, affecting more LPI and early premature infants, respectively. The GA was inversely proportional to the length of hospital stay. The term newborns died more than the LPI and less than the early preterm infants. CONCLUSION: The LPI offer a large number of occurrences in the neonatal period and are therefore a high risk group, requiring special attention. Prenatal care is still deficient in the detection of risk factors for prematurity that could be prevented or avoided. The mortality rate of LPI was equivalent to the populations of studies presented in the international literature, but early preterm and term infants mortality rates were higher, reinforcing the need for specific studies in these groups.