Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers

• Autor(a) principal: Guinsburg, Ruth
• Data de Publicação: 2016
• Outros Autores: Branco de Almeida, Maria Fernanda, Castro, Junia Sampel de, Silveira, Rita C., Siqueira Caldas, Jamil Pedro de, Fiori, Humberto Holmer, Vale, Marynea Silva do, Steffen Abdallah, Vania Olivetti, Monteiro Bigelli Cardoso, Laura Emilia, Alves Filho, Navantino, Moreira, Maria Elisabeth, Acquesta, Ana Lucia, Lopes Ferrari, Ligia S., Bentlin, Maria Regina [UNESP], Venzon, Paulyne Stadler, Goncalves Ferri, Walusa Assad, Meneses, Jucille do Amaral, De Albuquerque Diniz, Edna Maria, Toledo Zanardi, Dulce Maria, Dos Santos, Cristina Nunes, Bandeira Duarte, Jose Luiz, Santiago Rego, Maria Albertina
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.3109/14767058.2015.1031740; http://hdl.handle.net/11449/164700
• topic: Bronchopulmonary dysplasia; intraventricular hemorrhage; neonatal mortality; periventricular leukomalacia; preterm newborn infant; retinopathy of prematurity; very low birth weight newborn infant

Objective: To analyze unfavorable outcomes at hospital discharge of preterm infants born at Brazilian public university centers.Methods: Prospective cohort of 2646 inborn infants with gestational age 23-33 weeks and birth weight 400-1499g, without malformations, born at 20 centers in 2012-2013. Unfavorable outcome was defined as in-hospital death or survival at hospital discharge with 1 major morbidities: bronchopulmonary dysplasia (BPD) at 36 corrected weeks, intraventricular hemorrhage (IVH) grades 3-4, periventricular leukomalacia (PVL) or surgically treated retinopathy of prematurity (ROP).Results: Among 2646 infants, 1390 (53%) either died or survived with major morbidities: 793 (30%) died; 497 (19%) had BPD; 358 (13%) had IVH 3-4 or PVL; and 84 (3%) had ROP. Logistic regression adjusted by center showed association of unfavorable outcome with: antenatal steroids (OR 0.70; 95%CI 0.55-0.88), C-section (0.72; 0.58-0.90), gestational age <30 (4.00; 3.16-5.07), being male (1.44; 1.19-1.75), small for gestational age (2.19; 1.72-2.78), 5th-min Apgar <7 (3.89; 2.88-5.26), temperature at NICU admission <36.0 degrees C (1.42; 1.15-1.76), respiratory distress syndrome (3.87; 2.99-5.01), proven late sepsis (1.33; 1.05-1.69), necrotizing enterocolitis (3.10; 2.09-4.60) and patent ductus arteriosus (1.69; 1.37-2.09).Conclusions: More than half of the VLBW infants born at public university level 3 Brazilian hospitals either die or survive with major morbidities.