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Perinatal factors associated with early neonatal deaths in very low birth weight preterm infants in Northeast Brazil.

Castro EC, Leite ÁJ, Almeida MF, Guinsburg R - BMC Pediatr (2014)

Bottom Line: Prospective cohort study of inborns with gestational age 23(0/7)-31(6/7) weeks and birthweight 500-1499 g without malformations in 19 public reference hospitals of the state capitals of Brazil's Northeast Region.Perinatal variables associated with early neonatal death were determined by Cox regression analysis.Among 627 neonates, 179 (29%) died with 0-6 days after birth.

View Article: PubMed Central - PubMed

Affiliation: Neonatal Unit of Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará, 3678 aptº 1600 - Meireles, CEP: 60165-121, Fortaleza, CE, Brazil. evelinecamposmc@gmail.com.

ABSTRACT

Background: In Brazil, the prevalence of prematurity has increased in recent years and it is a major cause of death in the neonatal period. Therefore, this study aims at assessing perinatal factors associated with early neonatal deaths in very low birth weight preterm infants born in a region of Brazil with low Human Development Index.

Methods: Prospective cohort study of inborns with gestational age 23(0/7)-31(6/7) weeks and birthweight 500-1499 g without malformations in 19 public reference hospitals of the state capitals of Brazil's Northeast Region. Perinatal variables associated with early neonatal death were determined by Cox regression analysis.

Result: Among 627 neonates, 179 (29%) died with 0-6 days after birth. Early death was associated to: absence of antenatal steroids (HR 1.59; 95% CI 1.11-2.27), multiple gestation (1.95; 1.28-3.00), male sex (2.01; 1.40-2.86), 5th minute Apgar <7 (2.93; 2.03-4.21), birthweight <1000 g (2.58; 1.70-3.88), gestational age <28 weeks (2.07; 1.42-3.02), use of surfactant (1.65; 1.04-2.59), and non-use of a pain scale (1.89; 1.24-2.89).

Conclusion: Biological variables and factors related to the quality of perinatal care were associated with the high chance of early death of preterm infants born in reference hospitals of Northeast Brazil.

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Related in: MedlinePlus

Percentage of neonates that died up between 0–6 days after birth according to gestational ages (weeks).
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Fig2: Percentage of neonates that died up between 0–6 days after birth according to gestational ages (weeks).

Mentions: Among the 627 infants in the study, 179 (29%) died within the first 0–6 days hours of life. Of these, 59 (33%) died within the first 24 hours of life. The following distribution of deaths according to gestational age should be noted: the study included 216 patients between 23–27 weeks, of whom 38 (18%) died within 24 hours and 106 (49%) within 0–6 days after birth; 411 neonates were born between 28–31 weeks, of whom 21 (5%) died within 24 hours and 73 (18%) within 0–6 days after birth. The distribution of early neonatal deaths per 100 g strata of birth weight and per week of gestational age is shown in Figures 1 and 2, respectively. Early neonatal mortality was present in 26% (125/476) of patients born in L1 hospitals and 36% (54/151) of those born in L2 hospitals (p = 0.024). When hospitals were divided by number of intensive care beds, 25% (104/423) of neonates born in centers with more than 10 beds died in the first week of life and the same occurred for 37% (75/204) of those born in centers with 10 or less intensive care bed (p = 0.002). According to the Kaplan-Meier analysis, the probability of survival of the studied patients in the first week of life was 72%.Figure 1


Perinatal factors associated with early neonatal deaths in very low birth weight preterm infants in Northeast Brazil.

Castro EC, Leite ÁJ, Almeida MF, Guinsburg R - BMC Pediatr (2014)

Percentage of neonates that died up between 0–6 days after birth according to gestational ages (weeks).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4308919&req=5

Fig2: Percentage of neonates that died up between 0–6 days after birth according to gestational ages (weeks).
Mentions: Among the 627 infants in the study, 179 (29%) died within the first 0–6 days hours of life. Of these, 59 (33%) died within the first 24 hours of life. The following distribution of deaths according to gestational age should be noted: the study included 216 patients between 23–27 weeks, of whom 38 (18%) died within 24 hours and 106 (49%) within 0–6 days after birth; 411 neonates were born between 28–31 weeks, of whom 21 (5%) died within 24 hours and 73 (18%) within 0–6 days after birth. The distribution of early neonatal deaths per 100 g strata of birth weight and per week of gestational age is shown in Figures 1 and 2, respectively. Early neonatal mortality was present in 26% (125/476) of patients born in L1 hospitals and 36% (54/151) of those born in L2 hospitals (p = 0.024). When hospitals were divided by number of intensive care beds, 25% (104/423) of neonates born in centers with more than 10 beds died in the first week of life and the same occurred for 37% (75/204) of those born in centers with 10 or less intensive care bed (p = 0.002). According to the Kaplan-Meier analysis, the probability of survival of the studied patients in the first week of life was 72%.Figure 1

Bottom Line: Prospective cohort study of inborns with gestational age 23(0/7)-31(6/7) weeks and birthweight 500-1499 g without malformations in 19 public reference hospitals of the state capitals of Brazil's Northeast Region.Perinatal variables associated with early neonatal death were determined by Cox regression analysis.Among 627 neonates, 179 (29%) died with 0-6 days after birth.

View Article: PubMed Central - PubMed

Affiliation: Neonatal Unit of Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará, 3678 aptº 1600 - Meireles, CEP: 60165-121, Fortaleza, CE, Brazil. evelinecamposmc@gmail.com.

ABSTRACT

Background: In Brazil, the prevalence of prematurity has increased in recent years and it is a major cause of death in the neonatal period. Therefore, this study aims at assessing perinatal factors associated with early neonatal deaths in very low birth weight preterm infants born in a region of Brazil with low Human Development Index.

Methods: Prospective cohort study of inborns with gestational age 23(0/7)-31(6/7) weeks and birthweight 500-1499 g without malformations in 19 public reference hospitals of the state capitals of Brazil's Northeast Region. Perinatal variables associated with early neonatal death were determined by Cox regression analysis.

Result: Among 627 neonates, 179 (29%) died with 0-6 days after birth. Early death was associated to: absence of antenatal steroids (HR 1.59; 95% CI 1.11-2.27), multiple gestation (1.95; 1.28-3.00), male sex (2.01; 1.40-2.86), 5th minute Apgar <7 (2.93; 2.03-4.21), birthweight <1000 g (2.58; 1.70-3.88), gestational age <28 weeks (2.07; 1.42-3.02), use of surfactant (1.65; 1.04-2.59), and non-use of a pain scale (1.89; 1.24-2.89).

Conclusion: Biological variables and factors related to the quality of perinatal care were associated with the high chance of early death of preterm infants born in reference hospitals of Northeast Brazil.

Show MeSH
Related in: MedlinePlus