Morbidade neonatal dos recém-nascidos pré-termo tardios comparados aos de termo precoce
DOI:
https://doi.org/10.15448/1980-6108.2017.1.25876Palavras-chave:
recém-nascido, prematuro, morbidade.Resumo
DOI: 10.15448/1980-6108.2017.1.25876
Objetivos: Avaliar e comparar a morbidade neonatal entre recém-nascidos pré-termo tardios (RNPT-T) e recém-nascidos de termo precoce (RNT-P).
Métodos: Estudo transversal retrospetivo, incluindo nascidos vivos em uma maternidade hospitalar de referência regional em Portugal, nos anos de 2014 e 2015, com idade gestacional entre 340/7 e 386/7 semanas. Os RNPT-T (340/7 - 366/7semanas) foram considerados casos e os RNT-P (370/7 - 386/7 semanas) foram considerados controles. Foram excluídos recém-nascidos com malformações congênitas, ausência de acompanhamento pré-natal e internação por motivo social ou causa materna. Foi avaliada e comparada a morbidade neonatal entre os dois grupos, utilizando o teste t de Student para comparação entre médias (variáveis contínuas) e o Qui-quadrado ou teste de Fisher para comparação entre variáveis categóricas. As odds ratio (OR) com seus respetivos intervalos de confiança (IC) 95% foram ajustadas (ORa) ao peso de nascimento, tipo de parto, patologia materna e gemelaridade. Considerou-se o valor p<0.05 como estatisticamente significativo.
Resultados: Foram avaliados 1.745 recém-nascidos, sendo 324 casos (RNPT-T) e 1.421 controles (RNT-P). Os RNPT-T associaram-se a maior frequência de hipertensão materna e diabetes gestacional e maiores taxas de gemelaridade e de cesariana. Os RNPT-T tiveram também um maior risco de necessidade de reanimação (OR=2,0 IC95% 1,3-3,0); hipoglicemia (ORa=4,9 IC95% 2,9-8,2); hiperbilirrubinemia (ORa=4,8 IC95% 3,7-6,2), taquipneia transitória (ORa=6,4 IC95% 4,0-10,3); dificuldades alimentares (ORa=6,6 IC95% 4,8-8,9); sepsis (ORa=4,4 IC95% 4,8-8,9); permanência hospitalar ≥5 dias (ORa=8,6 IC95% 6,6-11,3); e menor taxa de aleitamento materno exclusivo (ORa=0,2 IC95% 0,15-0,3).
Conclusões: Em comparação aos RNT-P, os RNPT-T apresentaram maior risco de morbidade. Este estudo reforça a necessidade de um seguimento clínico apropriado aos RNPT-T no período neonatal.Downloads
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