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-Characteristics of the premature infants who died before 168 hours compared to those who survived beyond that point Hospital death before 168 hours
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OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospital...
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Citations
... Despite improved survival rates of neonates worldwide, the survival of preterm and low birthweight babies is still a challenge, especially in middle-and low-income countries. [1][2][3][4] In 2018, WHO described a worldwide increase of babies born prematurely over the last two decades. The incidence has been estimated between 5% and 18% of all life births. ...
Background
Neonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.
Methods
This is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.
Results
173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.
Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.
Conclusion
This prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.
... Melhorias nos cuidados neonatais têm contribuído para aumentar a sobrevida dos recém-nascidos prematuros de muito baixo peso ao nascer e, consequentemente, reduzido [1][2][3] Podendo ainda se observar nesse grupo de pacientes frequentes complicações, internações prolongadas e sequelas, sendo fatores determinantes para dados da morbimortalidade. 1,4,5 As malformações congênitas continuam a ser importantes causas de mortalidade infantil nessa faixa etária, sendo a cardiopatia congênita (CC) uma das responsáveis por esses resultados. 6-8 a população de terapia intensiva neonatal, dado que o baixo peso ao nascer e bebês pequenos para a idade gestacional são fatores de alto risco, 9 com prevalência de 10,7% a 40,7% dos nascimentos. ...
Introducao: malformacoes congenitas sao importantes causas de mortalidade infantil nos recem-nascidos (RNs) prematuros, sendo a cardiopatia congenita (CC) uma das responsaveis. Objetivo: demonstrar o perfil clinico e epidemiologico dos RNs submetidos a cirurgia de correcao de persistencia do canal arterial (PCA) a beira do leito. Material e Metodos: estudo longitudinal retrospectivo, realizado nas Unidades de Terapia Intensiva Neonatal de um hospital terciario, no periodo de janeiro a dezembro de 2015. Resultados: a maioria dos pacientes foram RNs de extremo baixo peso e do sexo feminino, que apresentaram as mais variadas manifestacoes clinicas e complicacoes como hemorragia peri-intraventricular, insuficiencia real e displasia broncopulmonar, mesmo tendo feito uso de corticoide antenatal, surfactante e suporte ventilatorio. Conclusao: RNs submetidos a cirurgia foram aqueles prematuros extremos, do sexo feminino e extremo baixo peso ao nascer, que sofreram com complicacoes maternas ainda no periodo gestacional.
... On average, the one-tenth (0.1) variation in IMR corresponded to the effect magnitude of 63.7 infant deaths per thousand live births. Considering the average annual 22 number of live births during the study period (1996---2012), which was 636,888, the annual estimated drop of 0.65‰ LB in IMR corresponded to the mean annual reduction of 414 deaths ( Fig. 1 and Table 1). The early neonatal IMR ranged from 11.7‰ to 5.7‰ LB, down 51.3%; late neonatal ranged from 3.1‰ to 2.2‰ LB, down 28.2%; and post-neonatal ranged from 7.7‰ to 3.6‰ LB, down 52.9%. ...
... LB). 3 Neonatal mortality is a result of the quality of prenatal consultations care for women during pregnancy, childbirth, and newborn +Model RPPEDE-155; No. of Pages 8 6 Areco KC et al. 11.9 11.6 11.5 6.5 6.5 6. care. 3,21,22 Many neonatal deaths can be avoided, even in premature with very low birth weight. 22 Accounting for about half of infant deaths, the early neonatal group also stood out with the highest average annual reduction in mortality rate during the 17 years studied. ...
... 3,21,22 Many neonatal deaths can be avoided, even in premature with very low birth weight. 22 Accounting for about half of infant deaths, the early neonatal group also stood out with the highest average annual reduction in mortality rate during the 17 years studied. Therefore, variations in mortality in this age group have great impact on child mortality. ...
Objective
To describe trends and composition of infant mortality rate in the State of São Paulo, from 1996 to 2012.
Methods
An ecological study was conducted, based on official secondary data of births and infant deaths of residents in São Paulo, from 1996 to 2012. The infant mortality rate was calculated by the direct method and was analyzed by graphs and polynomial regression models for age groups (early neonatal, late neonatal and post-neonatal) and for groups of avoidable causes of death.
Results
The mortality rate in the State of São Paulo tended to fall, ranging from 22.5 to 11.5 per thousand live births. Half of the infant deaths occurred in the early neonatal group. The proportion of avoidable infant deaths varied from 76.0 to 68.7%. The deaths which were avoidable by adequate attention to women during pregnancy and childbirth and newborn care accounted for 54% of infant deaths throughout the period.
Conclusions
The mortality rate levels are still far from those in developed countries, which highlight the need to prioritize access and quality of healthcare services during pregnancy, childbirth and newborn care, especially in the first week of life, aiming at achieving standards of infant mortality similar to those of developed societies.
... 1,3,20 Em 2011, a TMI neonatal paulista foi menor do que a brasileira (11,1‰ NV) e semelhante à da região Sudeste (8,0‰ NV). 3 A mortalidade neonatal é consequência da qualidade das consultas pré-natais e do atendimento à gestante no parto e ao recém--nascido. 3,21,22 Muitos óbitos neonatais podem ser evitados, até mesmo em prematuros de muito baixo peso. 22 Contribuindo com cerca de metade dos óbitos infantis, o grupo neonatal precoce também se destacou por apresentar a maior redução anual média na taxa de mortalidade nos 17 anos estudados. ...
... 3,21,22 Muitos óbitos neonatais podem ser evitados, até mesmo em prematuros de muito baixo peso. 22 Contribuindo com cerca de metade dos óbitos infantis, o grupo neonatal precoce também se destacou por apresentar a maior redução anual média na taxa de mortalidade nos 17 anos estudados. Portanto, as variações da mortalidade nesse grupo etário têm grande impacto na mortalidade infantil. ...
... 2,13 A lista adotada no presente estudo considera causas evitáveis de óbito as morbidades relacionadas aos extremos de tempo de gestação (curto ou longo) e de peso ao nascer (baixo ou elevado), que são condições de nascimento comumente associadas ao risco de morte. 2,22 Os óbitos analisados referem-se aos usuários do sistema de saúde público (SUS) e suplementar do Estado de São Paulo, porém não foi possível quantificar a contribuição de cada sistema na mortalidade infantil, já que essa informação não é contemplada no SIM. Pode-se ter uma ideia da participação dos serviços de saúde suplementares aos serviços do SUS a partir da taxa de cobertura de tais serviços, que variou de 38,2% em 2000 a 45,3% em 2014. ...
Objective:
To describe trends and composition of infant mortality rate in the State of São Paulo, from 1996 to 2012.
Methods:
An ecological study was conducted, based on official secondary data of births and infant deaths of residents in São Paulo, from 1996 to 2012. The infant mortality rate was calculated by the direct method and was analyzed by graphs and polynomial regression models for age groups (early neonatal, late neonatal and post-neonatal) and for groups of avoidable causes of death.
Results:
The mortality rate in the State of São Paulo tended to fall, ranging from 22.5 to 11.5 per thousand live births. Half of the infant deaths occurred in the early neonatal group. The proportion of avoidable infant deaths varied from 76.0 to 68.7%. The deaths which were avoidable by adequate attention to women during pregnancy and childbirth and newborn care accounted for 54% of infant deaths throughout the period.
Conclusions:
The mortality rate levels are still far from those in developed countries, which highlight the need to prioritize access and quality of healthcare services during pregnancy, childbirth and newborn care, especially in the first week of life, aiming at achieving standards of infant mortality similar to those of developed societies.
... The characteristics of the newborns were evaluated according to gestational age (calculated by the unit's neonatologist using data on the last menstrual period as the first option, followed by ultrasound data and data obtained using the New Ballard method), 11 birth weight, presence of multiple gestations, Apgar score in the first and fifth minutes and the severity score, SNAPPE II (Score for Neonatal Acute Physiology Perinatal Extension). 12,13 In relation to the therapies used in this study, the follow- ...
... Thus, the mortality rate was much lower than the national mortality rate of 60% for children born at this weight. 13 This includes all preterm infants assessed. In the Brazilian literature, ROP incidence rates of 29.1%, 13 28.5% 9 and 27.2% 14 have been described. ...
... 13 This includes all preterm infants assessed. In the Brazilian literature, ROP incidence rates of 29.1%, 13 28.5% 9 and 27.2% 14 have been described. These studies fell within a similar range of incidence rates and showed the highest rate for stage I ROP, which was about the same as what was found in the present study. ...
Retinopathy of prematurity (ROP) is a known cause of blindness in which diagnosis and timely treatment can prevent serious harm to the child. This study aimed to evaluate the incidence of ROP and its association with known risk factors.
Longitudinal incidence study in the neonatal intensive care unit (NICU) of Universidade Estadual de Montes Claros.
Newborns admitted to the NICU with gestational age less than 32 weeks and/or birth weight less than 1,500 grams, were followed up over a two-year period. The assessment and diagnosis of ROP were defined in accordance with a national protocol. The chi-square test or Fisher's exact test were used to determine associations between independent variables and ROP. Analysis on the independent effect of the variables on the results was performed using multiple logistic regression.
The incidence of ROP was 44.5% (95% confidence interval, CI = 35.6-46.1) in the study population. The risk factors associated with the risk of developing the disease were: birth weight less than 1,000 grams (odds ratio, OR = 4.14; 95% CI = 1.34-12.77); gestational age less than 30 weeks (OR = 6.69; 95% CI = 2.10-21.31); use of blood derivatives (OR = 4.14; 95% CI = 2.99-8.99); and presence of sepsis (OR = 1.99; 95% CI = 1.45-2.40).
The incidence of ROP was higher than that found in the literature. The main risk factors were related to extreme prematurity.
A retinopatia da prematuridade (ROP) é causa conhecida de cegueira e diagnóstico e tratamento oportunos podem evitar graves danos à criança. Este estudo objetivou avaliar a incidência da ROP e sua associação com fatores de risco conhecidos.
The nurse manager performs duties in an environment whose working
conditions can be too stressful. The Covid-19 pandemic further increased the stressors to which the nursing team and consequently the manager are exposed. This chapter, whose objective was to discuss the
burnout syndrome in nurse managers, was elaborated through the reading, analysis and interpretation of studies found in the Virtual Health
Library and in Google Academic. Studies determined that nurse managers have high levels of emotional exhaustion and depersonalization.
Age, sex, marital status, having children, and the occurrence of mobbing are related to the burnout syndrome. The nurse manager’s illness
affects the entire team and consequently interferes negatively with care.
Support from the nursing team and the health institution’s administration
will contribute to the prevention of burnout syndrome in nurse managers.
Keywords: Nursing; Nurse Administrators; Nurses; Burnout, Professional; Occupational Risks
RESUMOObjetivo: avaliar a efetividade do escore SNAPPE II como preditor de óbito neonatal. Método: revisão integrativa na qual foram utilizadas as bases de dados MEDLINE/PUBMED, SCOPUS, WEB OF SCIENCE e LILACS. Artigos completos, disponíveis e publicados nos últimos dez anos, em qualquer idioma, foram os critérios utilizados. Resultados: a amostra resultou em oito artigos examinados mediante um instrumento adaptado de Ursi. As pesquisas mostraram que os escores avaliados são bons preditores de óbito hospitalar, porém, não de morbidade e nem de permanência hospitalar. Conclusão: a possibilidade de medir a gravidade da doença do recém-nascido na unidade de terapia intensiva neonatal, por meio da utilização dos escores de gravidade, permite a comparação adequada entre os serviços e a padronização das boas práticas perinatais e neonatais colaborando para a redução da mortalidade neonatal e infantil. Descritores: Morte Perinatal; Mortalidade; Pesquisa Sobre Serviços de Saúde; Guia de Prática Clínica; Índice de Gravidade de Doença; Mortalidade Infantil.ABSTRACTObjective: to evaluate the effectiveness of the SNAPPE II score as a predictor of neonatal death. Method: integrative review using the MEDLINE / PUBMED, SCOPUS, WEB OF SCIENCE and LILACS databases. Complete articles, available and published in the last ten years, in any language, were the criteria used. Results: the sample resulted in eight articles examined using an instrument adapted from Ursi. The researches showed that the scores evaluated are good predictors of hospital death, but not of morbidity or hospital stay. Conclusion: the possibility of measuring the severity of neonatal disease in the neonatal intensive care unit, through the use of severity scores, allows an adequate comparison between services and the standardization of good perinatal and neonatal practices, contributing to the reduction of neonatal and infant mortality. Descriptors: Perinatal Death; Mortality; Health Services Research; Practice Guideline; Severity of Illness Index; Infant Mortality.RESUMENObjetivo: evaluar la efectividad del score SNAPPE II como predictor de óbito neonatal. Método: revisión integrativa que se utilizó como base de datos MEDLINE / PUBMED, SCOPUS, WEB OF SCIENCE y LILACS. Artículos completos, disponibles y publicados en los últimos diez años, en cualquier idioma, fueron los criterios utilizados. Resultados: la muestra resultó en ocho artículos, examinados mediante un instrumento adaptado de Ursi. Las investigaciones mostraron que los puntajes evaluados son buenos predictores de óbito hospitalario, pero, no de morbilidad y no de permanencia hospitalaria. Conclusión: la posibilidad de medir la gravedad de la enfermedad del recién nacido en la unidad de terapia intensiva neonatal, por medio de la utilización de los puntajes de gravedad, permite la comparación adecuada entre los servicios y la estandarización de las buenas prácticas perinatales y neonatales, colaborando para la reducción de la mortalidad neonatal e infantil. Descriptores: Muerte Perinatal; Mortalidad; Investigación en Servicios de Salud; Guía de Práctica Clínica; Índice de Severidade de la Enfermidade;Mortalidad Infantil.
OBJETIVO: Analisar os fatores relacionados aos obitos em criancas menores de 28 dias de vida durante o ano de 2014 em um hospital pediatrico terciario. METODOLOGIA: Estudo observacional, transversal, analitico, retrospectivo e descritivo realizado no Hospital Infantil Albert Sabin/HIAS no periodo de janeiro a dezembro de 2014 (12 meses). Foram incluidos obitos, independente de tempo de hospitalizacao, preenchimento de declaracao de obito ou submissao a necropsia. O banco de dados foi formatado usando o programa SPSS 13.0 for Windows e analises univariadas descritivas (frequencia, media, mediana, desvio padrao). RESULTADOS: A amostra conta com registro de 64 obitos, com discreto predominio do sexo feminino (51,6%), idade media de admissao foi de 3,2±1 dias, 50% dos neonatos que foram a obito pesavam menos de 2.500 gramas. Os principais motivos de referencia foram prematuridade (28,5%) e dispneia (23,4%). Quanto a qualidade desse transporte 73,4% foram regulados e 58,7% nao foram acompanhados por medicos. A causa basica de obitos foi a prematuridade e causa imediata choque septico. CONCLUSAO: A baixa qualidade da assistencia perinatal, o parto prematuro, o baixo peso e o transporte pos-natal inadequado sao os grandes contribuintes das taxas de mortalidade neonatal, sobretudo antes do 7o dia de vida.
Introduction:
The analysis of deaths occurred in the neonatal period and the association of these data to necropsy data are crucial to reduce infant mortality rate worldwide.
Objective:
To analyze the preventable causes of death and the factors associated with a higher risk of early newborn death.
Methods:
A cross-sectional and descriptive study was performed with data about newborns that died during the neonatal period at a university hospital located in Curitiba; 314 cases of pediatric necropsies were selected, and preventable causes of death, survival time, sex, weight, gestational age, first- and fifth-minute Apgar score, cyanosis, acidosis, meconium aspiration, the need for oxygen resuscitation, cause of death and baseline disease were analyzed.
Results:
When considering only the cause of death, 300 cases (95.54%) would have preventable causes, but when analyzing the underlying disease, the number of cases decreased to 209 (66.56%). The most frequent cause of death was hypoxia (85%), and the main baseline disease was diffuse alveolar damage (52.9%). There was a positive association between these variables with survival time: cyanosis (p = 0.02), gestational age (p = 0.012), cause of death (p < 0.001), Apgar score < 6 (p < 0.001) and pH value (p < 0.001).
Conclusion:
The incidence of preventable causes of death is probably lower when analyzed concurrently with the underlying disease. Cyanosis, gestational age, cause of death, Apgar < 6 and arterial blood pH are associated with survival time of newborns.
The most dramatic events in the growth and development occur before birth, and receive influence of genetic factors, hormonal, environmental, placental, nutrition and maternal health, which can exert influence in varying degrees, providing benefits or harms the growth pattern and fetal development. Among the premature, a higher incidence of disorders related to immaturity of organs and systems, and more likely to change and / or deviations in their acquisitions and development. Thus, the objective of this research was to evaluate the neurological development of newborns premature infants less than 34 weeks during the first three years of life that attended the Clinic of Premature of the Holy Para Mercy House Foundation ((FSCMPa). Therefore, treated a observational study of a retrospective cohort type, performed at the Clinic of premature of the Holy Para Mercy House Foundation with 90 premature infants enrolled from June 2008 to June 2009 and are considered premature infants, all infants with gestational age less than 37 weeks. The areas analyzed by the Denver II Test, there was no significant correlation in the analysis only on personal social area (p = 0.1496). Test results among VLBW infants characteristics and the outcome of the Denver II test tended to be correlated with results changed in the first year of life, male, (p = 0.0009), gestational age 27-29 weeks, gestational age (p = 0.0022) and from 33 weeks (p = 0.0398), weighing less than 1500 g (p = 0.0001) and exclusive breastfeeding time (p = 0.0001). It was observed in this study with the Denver test, high proportion of children carries an increased risk of developmental delays, especially in children born with gestational age of 34 weeks, during which can be seen most organic immaturity. Among the evaluated, delays can be noted that the first year of life to change in the overall motor development prevailed, but from the second year delay in the area of language prevailed.
