Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros

• Autor(a) principal: Luz, Lucyana Silva
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/6271
• topic: Amamentação; Prematuro; Enfermagem neonatal; Breastfeending; Premature; Neonatal nursing; CIENCIAS DA SAUDE::ENFERMAGEM

Prematurity is one of the main causes of infant mortality and morbidity associated with perinatal conditions, being responsible for the majority of neonatal deaths in Brazil. Exclusive Breastfeeding (EBF) is one of the main interventions for neonatal deaths reduction, being recommended for early start and keeping until six months of age. However, breastfeeding a premature infant (PT) is a challenge given its physiological and biological immaturity, unstable health and hospitalization. EBF level is low among PT and early weaning is frequent. It is important to know the factors that contribute to this circumstance. Thus, this study assessed EBF incidence and associated risk factors for EBF interruption in PT after 15 days of hospital discharge. It is a prospective cohort accomplished in a public maternity of Goiás with 113 PT admitted in the neonatal unit. Data about PT feeding, since birth until 15 days after hospital discharge, were collected from PT’s medical chart and interview with the mother using a semi-structured questionnaire. EBF interruption of PT 15 days after hospital discharge was considered as the outcome variable and several maternal and neonatal exposure variables were tested. Data quantitative analysis of PT’s gestation, birth and health conditions was done through descriptive statistics. Maternal and neonatal exposure effects on the outcome variable were evaluated through COX regression model. Variables that presented statistical significance (p<0.10) in the univariate analysis were included in the backward multivariate regression model. Significant variables in the model (p<0.05) were interpreted by the hazard ratio (Hazard Risk – HR) and the respective 95% confidence interval. EBF incidence was 81.4% in hospital discharge and 66.4% 15 days after hospital discharge. In the univariate analysis, variables: breast problems, double pregnancy, gestational age at birth, birth weight, admittance time, ventilation time and effective breastfeeding in the first week of life were statistically significant. In the multivariate analysis, variables double gestation, ventilation time and birth weight were statistically significant. A 15% decrease in EBF incidence can be verified 15 days after hospital discharge. EBF interruption risk at home is higher when PT is born from double pregnancy and the lower the PT’s birth weight. On the other side, EBF interruption risk at home is lower the lower the mechanic ventilation time. The implementation of actions is necessary by a multi-professional staff that promotes early start and keeping of EBF during hospitalization in the neonatal unit, as well as the articulation of these actions with basic care and public policies to increase EBF levels from birth up to six months of life.