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

• Autor(a) principal: Castro, Eveline Campos Monteiro de
• Data de Publicação: 2014
• Outros Autores: Leite, Alvaro Jorge Madeiro, Almeida, Maria Fernanda Branco de [UNIFESP], Guinsburg, Ruth [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1186/s12887-014-0312-5; http://repositorio.unifesp.br/handle/11600/38561
• topic: Premature newborn infant; Very low weight newborn infant; Neonatal mortality; Early neonatal mortality; Neonatal ICU

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.