Ruth Guinsburg1, Maria Fernanda Branco de Almeida1, Junia Sampel de Castro1, Rita C Silveira2, Jamil Pedro de Siqueira Caldas3, Humberto Holmer Fiori4, Marynéa Silva do Vale5, Vânia Olivetti Steffen Abdallah6, Laura Emilia Monteiro Bigélli Cardoso7, Navantino Alves Filho8, Maria Elisabeth Moreira9, Ana Lucia Acquesta10, Lígia S Lopes Ferrari11, Maria Regina Bentlin12, Paulyne Stadler Venzon13, Walusa Assad Gonçalves Ferri14, Jucille do Amaral Meneses15, Edna Maria De Albuquerque Diniz16, Dulce Maria Toledo Zanardi17, Cristina Nunes Dos Santos18, José Luiz Bandeira Duarte19, Maria Albertina Santiago Rego20. 1. a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil . 2. b Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil . 3. 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 . 4. d Department of Pediatrics , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil . 5. e Hospital Universitário da Universidade Federal do Maranhão , São Luís , MA , Brazil . 6. f Hospital de Clínicas, Faculdade de Medicina, Universidade Federal de Uberlândia , Uberlândia , MG , Brazil . 7. g Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil . 8. h Faculdade de Ciências Médicas de Minas Gerais , Belo Horizonte , MG , Brazil . 9. i Instituto Fernandes Figueira da Fundação Instituto Oswaldo Cruz , Rio de Janeiro , RJ , Brazil . 10. j Hospital Geral de Pirajussara , São Paulo , SP , Brazil . 11. k Hospital Universitário da Universidade Estadual de Londrina , Londrina , PR , Brazil . 12. l Faculdade de Medicina de Botucatu , Universidade Estadual Paulista , Botucatu , SP , Brazil . 13. m Department of Pediatrics , Universidade Federal do Paraná , Curitiba , PR , Brazil . 14. n Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto, São Paulo , SP , Brazil . 15. o Instituto de Medicina Integral Prof Fernando Figueira , Recife , PE , Brazil . 16. p Hospital Universitário da Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil . 17. q Hospital Estadual Sumaré , Sumaré , SP , Brazil . 18. r Hospital Estadual de Diadema , Diadema, São Paulo , SP , Brazil . 19. s Universidade Estadual do Rio de Janeiro , Rio de Janeiro , RJ , Brazil , and. 20. t Hospital das Clínicas, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil.
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.
OBJECTIVE: To analyze unfavorable outcomes at hospital discharge of preterm infants born at Brazilian public university centers. METHODS: Prospective cohort of 2646 inborninfants 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.
Authors: Rens Zonneveld; Natanael Holband; Anna Bertolini; Francesca Bardi; Neirude P A Lissone; Peter H Dijk; Frans B Plötz; Amadu Juliana Journal: BMC Pediatr Date: 2017-11-14 Impact factor: 2.125
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Authors: Ana Sílvia Scavacini Marinonio; Daniela Testoni Costa-Nobre; Milton Harumi Miyoshi; Rita de Cassia Xavier Balda; Kelsy Catherina Nema Areco; Tulio Konstantyner; Mandira Daripa Kawakami; Adriana Sanudo; Paulo Bandiera-Paiva; Rosa Maria Vieira de Freitas; Lilian Cristina Correia Morais; Mônica La Porte Teixeira; Bernadette Cunha Waldvogel; Maria Fernanda Branco de Almeida; Ruth Guinsburg; Carlos Roberto Veiga Kiffer Journal: BMC Public Health Date: 2022-06-20 Impact factor: 4.135