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  • Artigos Originais

    Correlation between antenatal corticosteroid therapy, resuscitation and mortality in very low birth weight infants

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(5):211-215

    Summary

    Artigos Originais

    Correlation between antenatal corticosteroid therapy, resuscitation and mortality in very low birth weight infants

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(5):211-215

    DOI 10.1590/S0100-7203201400050005

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    PURPOSE:

    To evaluate the correlation between the use of antenatal corticosteroid therapy (AC), the frequency of resuscitation in delivery room and mortality of newborn infants under 1,500 g and gestational age less than or equal to 34 weeks.

    METHODS:

    A cohort study was conducted on all newborn infants under 1,500 g and with a gestational age less than or equal to 34 weeks admitted at the neonatal ICU between January 2006 and December 2011. Newborns who had congenital anomalies, genetic syndromes, congenital infections and those who were transferred to or came from other institutions were excluded. The studied infants were divided into 2 groups: those who received (n=182) and those who did not receive (n=38) AC. The main outcomes studied were the necessity of neonatal resuscitation, the presence of the main neonatal diseases and mortality during hospitalization. The means of the variables were compared using Student's t-test or non-parametric test and frequencies were compared by χ2test with Fisher's correction. The variables that presented difference between groups were assessed by logistic regression. The Statistical Package for the Social Sciences (SPSS) 16.0 was used and the significance level was set at 0.05.

    RESULTS:

    In this study, 220 patients were evaluated. The groups were similar concerning birth weight, gestational age and the presence of the main neonatal morbidity during hospitalization. The infants who received antenatal corticosteroids showed lower mortality (OR=3.0; 95%CI 1.4-6.5) and required less resuscitation (OR=2.4; 95%CI 1.1-5.0). Besides, they required less advanced resuscitation procedures, such as tracheal cannula (OR=3.7; 95%CI 1.7-7.6), cardiac massage (OR=5.7; 95%CI 2.0-16.5) and medications (OR=8.9; 95%CI 2.0-39.4).

    CONCLUSIONS:

    The use of antenatal corticosteroids reduced the need for resuscitation in delivery room, especially advanced procedures, and reduced the mortality in the studied groups.

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  • Artigos Originais

    Evaluation of perinatal factors that influence the incidence of necrotizing enterocolitis in very low birth weight infants

    Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):363-367

    Summary

    Artigos Originais

    Evaluation of perinatal factors that influence the incidence of necrotizing enterocolitis in very low birth weight infants

    Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):363-367

    DOI 10.1590/S0100-72032013000800005

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    PURPOSE: To evaluate the perinatal factors that influence the incidence of necrotizing enterocolitis (NEC) in newborns infants (NBI) weighing less than 1,500 g. METHODS: A prospective study that analyzed all infants with birth weight (BW) less than 1,500 g born between January 2006 to December 2010 (n=183). They were divided into two groups, i.e. infants diagnosed with NEC (n=18) and infants without a diagnosis of NEC (n=165), which were compared in terms of perinatal factors that could influence the incidence of NEC. Mean data were compared by Student's t-test or nonparametric tests and percentages of categorical variables were compared by the χ² test. When the variables showed differences between groups, they were analyzed using logistic regression with the dependent variable as the presence of NEC. The statistical package used was SPSS 16.0 for Windows. RESULTS: The two groups were similar in terms of most of the clinical and demographic neonatal and maternal data, except for the presence of preeclampsia (PE), which was higher in patients whose children developed NEC (61.1 versus 35,6%). The presence of PE increased the chance of occurrence of NEC by 2.84 times (95%CI 1.0 - 7.7). CONCLUSION: The only factor that can interfere with the incidence of NEC in infants of very low birth weight was the presence of PE. Awareness of this fact can guide the perinatal team in providing more judicious care regarding the prevention of NEC in this specific population.

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