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Authors
Abstract(s)
Introdução: A prematuridade, definida como o nascimento que ocorre antes
das 37 semanas de gestação, representa cerca de 11% de todos os nascimentos sendo que
70-74% destes correspondem ao grupo dos recém-nascidos pré-termo tardios (nascidos
entre as 34-36 semanas e 6 dias de gestação). Continua a ser a principal causa de
morbimortalidade no período neonatal devido à maior imaturidade fisiológica desta
população.
Objetivos: Avaliar os fatores de risco na gestação e no parto associados à
prematuridade tardia bem como percecionar as consequências da prematuridade nos
recém-nascidos e no seu desenvolvimento.
Material e Métodos: Estudo transversal retrospetivo baseado na análise de
processos clínicos. Obteve-se uma amostra de 201 recém-nascidos, entre janeiro e julho
de 2019, no Centro Hospitalar Universitário Cova da Beira. Foram analisadas diversas
variáveis: características maternas, da gestação, do parto assim como características e
complicações do recém-nascido. A análise foi realizada recorrendo ao software
estatístico SPSS, versão 27.0. Procedeu-se à análise descritiva dos dados e utilizaram-se
métodos de estatística inferencial, considerando-se uma significância de 5%.
Resultados: Durante o período do estudo houve um total de 201 recémnascidos no Centro Hospitalar Universitário Cova da Beira, dos quais 97,5% (n=196)
eram recém-nascidos a termo e 2,5% (n=5) eram pré-termo tardios. Observou-se que as
gestações prematuras tardias apresentaram uma frequência 9 vezes superior de
distúrbios hipertensivos, como a hipertensão gestacional e Pré-eclâmpsia. Houve uma
maior probabilidade dos prematuros tardios necessitarem de protocolos de maturação
pulmonar com Corticosteróides (OR=41,571; [8,206; 210,598]) e de Sulfato de Magnésio
pré-natal (OR=32,833; [7,397; 145,746]). O grupo de estudo apresentou uma média de
peso inferior comparativamente aos recém-nascidos a termo (p<0,001) e maior
necessidade de suporte respiratório ao nascer (p=0,035). Diversas complicações
neonatais apresentaram uma relação significativa com a prematuridade tardia
nomeadamente hipoglicémia (p=0,013), icterícia com critérios para fototerapia
(p=0,009) e sépsis neonatal (p=0,003). A duração média da hospitalização foi superior
no grupo de estudo comparativamente aos recém-nascidos a termo, resultando numa
relação significativa entre as duas variáveis (p<0,001). Houve um aumento da
probabilidade dos prematuros tardios desenvolverem patologia nefro-urológica durante
o primeiro ano de vida (p=0,021). Conclusão: Os recém-nascidos pré-termo tardios correspondem ao maior
subgrupo de prematuros. Face à sua prematuridade, configuram um grupo de risco bem
definido para o desenvolvimento de complicações a curto e a longo prazo. Neste estudo
comprovamos a maior morbilidade deste grupo comparativamente aos seus pares a
termo demonstrando a importância de identificar fatores passíveis de intervenção
através de uma adequada assistência pré e pós-natal.
Introduction: Prematurity, defined as birth that occurs before 37 weeks of gestation, represents about 11% of all births, 70-74% of which correspond to the group of late preterm newborns (born between 34-36 weeks and 6 days of gestation). It continues to be the main cause of morbidity and mortality in the neonatal period due to the greater physiological immaturity of this population. Aims: To evaluate the risk factors in pregnancy and childbirth associated with late prematurity as well as to understand the consequences of prematurity in newborns and their development. Methodology: Cross-sectional retrospective study based on the analysis of clinical processes. A sample of 201 newborns was obtained between January and July 2019 at the Cova da Beira Hospital University Center. Several variables were analyzed: maternal, pregnancy, delivery characteristics as well as characteristics and complications of the newborn. The analysis was performed using the statistical software SPSS, version 27.0. Descriptive data analysis was performed and inferential statistical methods were used, considering a significance of 5%. Results: During the study period, there were a total of 201 newborns at the Cova da Beira Hospital University Center, of which 97.5% (n = 196) were full-term newborns and 2.5% (n=5) were late preterm newborns. It was observed that late premature pregnancies presented a 9 times higher frequency of hypertensive disorders, such as gestational hypertension and preeclampsia. Late preterm newborns were more likely to require pulmonary maturation protocols with corticosteroids (OR=41.571; [8,206; 210,598]) and antenatal magnesium sulfate (OR= 32.833; [7,397; 145,746]). The study group had a lower average weight compared to full-term newborns (p <0.001) and a greater need for respiratory support at birth (p=0.035). Several neonatal complications showed a significant relationship with late prematurity, namely hypoglycemia (p=0.013), jaundice with criteria for phototherapy (p=0.009) and neonatal sepsis (p = 0.003). The average duration of hospitalization was higher in the study group compared to full-term newborns, resulting in a significant relationship between the two variables (p<0.001). There was an increase in the probability of late preterm infants to develop nephrourological pathology during the first year of life (p=0.021). Conclusion: Late preterm newborns correspond to the largest subgroup of preterm infants. In view of their prematurity, they are a well-defined risk group for the development of complications in the short and long term. In this study, we proved the greater morbidity of this group compared to its full-term peers, demonstrating the importance of identifying factors that can be intervened through adequate pre and postnatal care.
Introduction: Prematurity, defined as birth that occurs before 37 weeks of gestation, represents about 11% of all births, 70-74% of which correspond to the group of late preterm newborns (born between 34-36 weeks and 6 days of gestation). It continues to be the main cause of morbidity and mortality in the neonatal period due to the greater physiological immaturity of this population. Aims: To evaluate the risk factors in pregnancy and childbirth associated with late prematurity as well as to understand the consequences of prematurity in newborns and their development. Methodology: Cross-sectional retrospective study based on the analysis of clinical processes. A sample of 201 newborns was obtained between January and July 2019 at the Cova da Beira Hospital University Center. Several variables were analyzed: maternal, pregnancy, delivery characteristics as well as characteristics and complications of the newborn. The analysis was performed using the statistical software SPSS, version 27.0. Descriptive data analysis was performed and inferential statistical methods were used, considering a significance of 5%. Results: During the study period, there were a total of 201 newborns at the Cova da Beira Hospital University Center, of which 97.5% (n = 196) were full-term newborns and 2.5% (n=5) were late preterm newborns. It was observed that late premature pregnancies presented a 9 times higher frequency of hypertensive disorders, such as gestational hypertension and preeclampsia. Late preterm newborns were more likely to require pulmonary maturation protocols with corticosteroids (OR=41.571; [8,206; 210,598]) and antenatal magnesium sulfate (OR= 32.833; [7,397; 145,746]). The study group had a lower average weight compared to full-term newborns (p <0.001) and a greater need for respiratory support at birth (p=0.035). Several neonatal complications showed a significant relationship with late prematurity, namely hypoglycemia (p=0.013), jaundice with criteria for phototherapy (p=0.009) and neonatal sepsis (p = 0.003). The average duration of hospitalization was higher in the study group compared to full-term newborns, resulting in a significant relationship between the two variables (p<0.001). There was an increase in the probability of late preterm infants to develop nephrourological pathology during the first year of life (p=0.021). Conclusion: Late preterm newborns correspond to the largest subgroup of preterm infants. In view of their prematurity, they are a well-defined risk group for the development of complications in the short and long term. In this study, we proved the greater morbidity of this group compared to its full-term peers, demonstrating the importance of identifying factors that can be intervened through adequate pre and postnatal care.
Description
Keywords
Desenvolvimento Intercorrências Morbilidade Recém-Nascidos A Termo Recém-Nascidos Pré-Termo Tardios