Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599 |
Resumo: | Introduction: Prematurity and low birth weight have been associated with increased neonatal morbidity and mortality. This study aimed to evaluate possible risk factors for prematurity associated with fetal growth restriction and being small for gestational age and to determine the incidence of morbidity in these two groups of infants.Material and Methods: Retrospective case-control study of newborns with gestational age of less than 32 weeks, with obstetric diagnosis of fetal growth restriction and with the clinical diagnosis of small for gestational age, admitted to the Neonatal Intensive Care Unit of a tertiary hospital for a period of six years.Results: A total of 356 newborns were studied, with an incidence of 11% of fetal growth restriction and 18% of small for gestational age. Pre-eclampsia was the risk factor for gestation with higher statistical significance (47% vs 16%, p < 0.001) in small for gestational age newborns. There was also a higher incidence of mild bronchopulmonary dysplasia (66% vs 38%, p = 0.005), late sepsis (59% vs 37%, p = 0.003), retinopathy of prematurity (58% vs 26%, p = 0.003) and necrotizing enterocolitis (20% vs 9%, p = 0.005). Mortality was similar in all three groups.Discussion: There were fewer newborn males diagnosed with fetal growth restriction during pregnancy compared to women. Significant differences were observed in the group of these infants regarding the occurrence of chorioamnionitis and pre-eclampsia in comparison to the control group. Newborns with fetal growth restriction and small for age had higher scores on clinical risk indices compared to the control group. In general, small for gestational age newborns had a higher incidence of morbidity than infants with fetal growth restriction and the control group.Conclusion: Advances in neonatal intensive care decreased mortality in preterm infants. However, there are still significant differences in the incidence of morbidity in newborns with growth compromise. The collaboration between obstetricians and neonatologists provides the basis for a correct clinical evaluation, early signaling and global intervention on these newborns, with a significant impact on short and long-term prognosis. |
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Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care CenterMorbilidade na Prematuridade Associada a Restrição do Crescimento Fetal e nos Prematuros Leves para a Idade Gestacional: Experiência de um Centro de ReferênciaFetal DevelopmentFetal Growth RetardationInfantPrematureSmall for Gestational AgeMorbidityAtraso do Crescimento FetalDesenvolvimento FetalMorbilidadeRecém-Nascido Pequeno para a Idade GestacionalRecém-Nascido PrematuroIntroduction: Prematurity and low birth weight have been associated with increased neonatal morbidity and mortality. This study aimed to evaluate possible risk factors for prematurity associated with fetal growth restriction and being small for gestational age and to determine the incidence of morbidity in these two groups of infants.Material and Methods: Retrospective case-control study of newborns with gestational age of less than 32 weeks, with obstetric diagnosis of fetal growth restriction and with the clinical diagnosis of small for gestational age, admitted to the Neonatal Intensive Care Unit of a tertiary hospital for a period of six years.Results: A total of 356 newborns were studied, with an incidence of 11% of fetal growth restriction and 18% of small for gestational age. Pre-eclampsia was the risk factor for gestation with higher statistical significance (47% vs 16%, p < 0.001) in small for gestational age newborns. There was also a higher incidence of mild bronchopulmonary dysplasia (66% vs 38%, p = 0.005), late sepsis (59% vs 37%, p = 0.003), retinopathy of prematurity (58% vs 26%, p = 0.003) and necrotizing enterocolitis (20% vs 9%, p = 0.005). Mortality was similar in all three groups.Discussion: There were fewer newborn males diagnosed with fetal growth restriction during pregnancy compared to women. Significant differences were observed in the group of these infants regarding the occurrence of chorioamnionitis and pre-eclampsia in comparison to the control group. Newborns with fetal growth restriction and small for age had higher scores on clinical risk indices compared to the control group. In general, small for gestational age newborns had a higher incidence of morbidity than infants with fetal growth restriction and the control group.Conclusion: Advances in neonatal intensive care decreased mortality in preterm infants. However, there are still significant differences in the incidence of morbidity in newborns with growth compromise. The collaboration between obstetricians and neonatologists provides the basis for a correct clinical evaluation, early signaling and global intervention on these newborns, with a significant impact on short and long-term prognosis.Introdução: A prematuridade e o baixo peso ao nascer têm sido associados a maior morbilidade e mortalidade neonatais. Este estudo teve como objetivo avaliar possíveis fatores de risco para a prematuridade associada a restrição do crescimento fetal e a recém-nascidos leves para a idade gestacional e determinar a incidência da morbilidade nestes dois grupos de recém-nascidos.Material e Métodos: Estudo caso-controlo retrospetivo dos recém-nascidos com idade gestacional inferior a 32 semanas, com o diagnóstico obstétrico de restrição do crescimento fetal e com o diagnóstico clínico de leves para a idade gestacional, internados na Unidade de Cuidados Intensivos Neonatais de um hospital terciário, durante um período de seis anos.Resultados: Foram estudados 356 recém-nascidos, observando-se uma incidência de 11% de restrição do crescimento fetal e 18% de leves para a idade gestacional. A pré-eclâmpsia foi o fator de risco da gestação com maior significado estatístico (47% vs 16%, p < 0,001) nos recém-nascidos leves para a idade gestacional. Observou-se também, nestes recém-nascidos, maior incidência de displasia broncopulmonar ligeira (66% vs 38%, p = 0,005), de sépsis tardia (59% vs 37%, p = 0,003), de retinopatia da prematuridade (58% vs 26%, p = 0,003) e de enterocolite necrotizante (20% vs 9%, p = 0,005). A mortalidade foi idêntica nos três grupos.Discussão: Encontraram-se menos recém-nascidos do sexo masculino diagnosticados com restrição do crescimento fetal durante a gravidez comparativamente ao sexo feminino. Observaram-se diferenças significativas no grupo destes recém-nascidos, quanto à ocorrência de corioamnionite e de pré-eclâmpsia, face ao grupo controlo. Tanto os recém-nascidos com restrição do crescimento fetal como os leves para a idade gestacional apresentaram uma pontuação mais elevada nos índices de risco clínico comparativamente ao grupo controlo. De forma global, os recém-nascidos leves para a idade gestacional tiveram maior incidência de morbilidade que os recém-nascidos com restrição do crescimento fetal e que o grupo controlo.Conclusão: Os avanços nos cuidados intensivos neonatais diminuíram a mortalidade nos recém-nascidos prematuros. Contudo, observam-se ainda diferenças significativas na incidência da morbilidade nos recém-nascidos com compromisso do crescimento. A colaboração entre obstetras e neonatalogistas constitui a base para uma correta avaliação clínica, sinalização precoce e intervenção global sobre estes recém-nascidos, com impacto significativo no prognóstico a curto e longo prazo.Ordem dos Médicos2018-11-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599oai:ojs.www.actamedicaportuguesa.com:article/9599Acta Médica Portuguesa; Vol. 31 No. 11 (2018): November; 648-655Acta Médica Portuguesa; Vol. 31 N.º 11 (2018): Novembro; 648-6551646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/5551https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/6061https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/9906https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/10768Direitos de Autor (c) 2018 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSilva, Noémia Rosado daOliveira, JoanaBerenguer, AlbertoGraça, André M.Abrantes, MargaridaMoniz, Carlos2022-12-20T11:05:46Zoai:ojs.www.actamedicaportuguesa.com:article/9599Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:43.778719Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center Morbilidade na Prematuridade Associada a Restrição do Crescimento Fetal e nos Prematuros Leves para a Idade Gestacional: Experiência de um Centro de Referência |
title |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
spellingShingle |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center Silva, Noémia Rosado da Fetal Development Fetal Growth Retardation Infant Premature Small for Gestational Age Morbidity Atraso do Crescimento Fetal Desenvolvimento Fetal Morbilidade Recém-Nascido Pequeno para a Idade Gestacional Recém-Nascido Prematuro |
title_short |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
title_full |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
title_fullStr |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
title_full_unstemmed |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
title_sort |
Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center |
author |
Silva, Noémia Rosado da |
author_facet |
Silva, Noémia Rosado da Oliveira, Joana Berenguer, Alberto Graça, André M. Abrantes, Margarida Moniz, Carlos |
author_role |
author |
author2 |
Oliveira, Joana Berenguer, Alberto Graça, André M. Abrantes, Margarida Moniz, Carlos |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Silva, Noémia Rosado da Oliveira, Joana Berenguer, Alberto Graça, André M. Abrantes, Margarida Moniz, Carlos |
dc.subject.por.fl_str_mv |
Fetal Development Fetal Growth Retardation Infant Premature Small for Gestational Age Morbidity Atraso do Crescimento Fetal Desenvolvimento Fetal Morbilidade Recém-Nascido Pequeno para a Idade Gestacional Recém-Nascido Prematuro |
topic |
Fetal Development Fetal Growth Retardation Infant Premature Small for Gestational Age Morbidity Atraso do Crescimento Fetal Desenvolvimento Fetal Morbilidade Recém-Nascido Pequeno para a Idade Gestacional Recém-Nascido Prematuro |
description |
Introduction: Prematurity and low birth weight have been associated with increased neonatal morbidity and mortality. This study aimed to evaluate possible risk factors for prematurity associated with fetal growth restriction and being small for gestational age and to determine the incidence of morbidity in these two groups of infants.Material and Methods: Retrospective case-control study of newborns with gestational age of less than 32 weeks, with obstetric diagnosis of fetal growth restriction and with the clinical diagnosis of small for gestational age, admitted to the Neonatal Intensive Care Unit of a tertiary hospital for a period of six years.Results: A total of 356 newborns were studied, with an incidence of 11% of fetal growth restriction and 18% of small for gestational age. Pre-eclampsia was the risk factor for gestation with higher statistical significance (47% vs 16%, p < 0.001) in small for gestational age newborns. There was also a higher incidence of mild bronchopulmonary dysplasia (66% vs 38%, p = 0.005), late sepsis (59% vs 37%, p = 0.003), retinopathy of prematurity (58% vs 26%, p = 0.003) and necrotizing enterocolitis (20% vs 9%, p = 0.005). Mortality was similar in all three groups.Discussion: There were fewer newborn males diagnosed with fetal growth restriction during pregnancy compared to women. Significant differences were observed in the group of these infants regarding the occurrence of chorioamnionitis and pre-eclampsia in comparison to the control group. Newborns with fetal growth restriction and small for age had higher scores on clinical risk indices compared to the control group. In general, small for gestational age newborns had a higher incidence of morbidity than infants with fetal growth restriction and the control group.Conclusion: Advances in neonatal intensive care decreased mortality in preterm infants. However, there are still significant differences in the incidence of morbidity in newborns with growth compromise. The collaboration between obstetricians and neonatologists provides the basis for a correct clinical evaluation, early signaling and global intervention on these newborns, with a significant impact on short and long-term prognosis. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-11-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599 oai:ojs.www.actamedicaportuguesa.com:article/9599 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599 |
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oai:ojs.www.actamedicaportuguesa.com:article/9599 |
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por eng |
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por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/5551 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/6061 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/9906 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9599/10768 |
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Direitos de Autor (c) 2018 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2018 Acta Médica Portuguesa |
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application/pdf application/pdf application/pdf application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 31 No. 11 (2018): November; 648-655 Acta Médica Portuguesa; Vol. 31 N.º 11 (2018): Novembro; 648-655 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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