학술논문
Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers.
Document Type
Academic Journal
Author
Guinsburg R; a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .; de Almeida MF; a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .; de Castro JS; a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .; Silveira RC; b Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil .; Caldas JP; c Hospital da Mulher Prof. José Aristodemo Pinotti, Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas , Campinas, São Paulo, , SP , Brazil .; Fiori HH; d Department of Pediatrics , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .; do Vale MS; e Hospital Universitário da Universidade Federal do Maranhão , São Luís , MA , Brazil .; Abdallah VO; f Hospital de Clínicas, Faculdade de Medicina, Universidade Federal de Uberlândia , Uberlândia , MG , Brazil .; Cardoso LE; g Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil .; Alves Filho N; h Faculdade de Ciências Médicas de Minas Gerais , Belo Horizonte , MG , Brazil .; Moreira ME; i Instituto Fernandes Figueira da Fundação Instituto Oswaldo Cruz , Rio de Janeiro , RJ , Brazil .; Acquesta AL; j Hospital Geral de Pirajussara , São Paulo , SP , Brazil .; Ferrari LS; k Hospital Universitário da Universidade Estadual de Londrina , Londrina , PR , Brazil .; Bentlin MR; l Faculdade de Medicina de Botucatu , Universidade Estadual Paulista , Botucatu , SP , Brazil .; Venzon PS; m Department of Pediatrics , Universidade Federal do Paraná , Curitiba , PR , Brazil .; Gonçalves Ferri WA; n Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto, São Paulo , SP , Brazil .; Meneses Jdo A; o Instituto de Medicina Integral Prof Fernando Figueira , Recife , PE , Brazil .; Diniz EM; p Hospital Universitário da Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil .; Zanardi DM; q Hospital Estadual Sumaré , Sumaré , SP , Brazil .; Dos Santos CN; r Hospital Estadual de Diadema , Diadema, São Paulo , SP , Brazil .; Bandeira Duarte JL; s Universidade Estadual do Rio de Janeiro , Rio de Janeiro , RJ , Brazil , and.; Rego MA; t Hospital das Clínicas, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil.
Source
Publisher: Informa Healthcare Country of Publication: England NLM ID: 101136916 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-4954 (Electronic) Linking ISSN: 14764954 NLM ISO Abbreviation: J Matern Fetal Neonatal Med Subsets: MEDLINE
Subject
Language
English
Abstract
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 400-1499 g, 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 °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.
Methods: Prospective cohort of 2646 inborn infants with gestational age 23-33 weeks and birth weight 400-1499 g, 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 °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.