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Objetivo: mensurar a prevalência de prematuridade segundo macrorregião brasileira e características maternas, nos últimos 11 anos; comparar as proporções durante a pandemia de covid-19 (2020-2021) com as da série histórica (2011-2019). Métodos: estudo ecológico, com dados do Sistema de Informações sobre Nascidos Vivos; prevalências calculadas segundo ano, macrorregião e características maternas; análise da série temporal pelo modelo de Prais-Winsten. Resultados: a prevalência de prematuridade em 2011-2021 foi de 11,1%, estável; a média no período pandêmico 11,3% (IC95% 11,2;11,4%) assemelhou-se à do período-base 11,0% (IC95% 10,6;11,5%); a região Norte (11,6%) apresentou a maior proporção entre 2011 e 2021; gestação gemelar (56,3%) e gestantes com 4-6 consultas de pré-natal (16,7%) apresentaram tendência crescente (p-valor < 0,001); observou-se maior prevalência para extremos de idade materna, gestantes de raça/cor da pele preta, indígenas e menor escolaridade. Conclusão: maior prematuridade nas gestantes socialmente vulneráveis, em gestações gemelares e no Norte; prevalência estável, sem diferença entre períodos.
Objetivo: medir la prevalência de prematuridad de 2011 a 2021, según macrorregión brasileña y características maternas, comparando los años de pandemia de COVID-19, con 2011-2019. Métodos: estudio ecológico basado en el Sistema de Información de Nacimientos Vivos. Prevalencias calculadas según año, macrorregión y características maternas. Análisis de series temporales por el modelo generalizado de Prais-Winsten. Resultados: la prematuridad entre 2011-2021 fue 11,1%, con estabilidade; la media de en el periodo de la pandemia 11,3% (IC95% 11,2;11,4) se asemejó a la media de referencia 11,0% (IC95% 10,6;11,5). Región del norte tuvo la proporción más alta entre 2011 y 2021. Embarazo gemelar y mujeres con 4-6 visitas prenatales tuvieron tendencia al aumento. Prevalencias más elevadas correspondían a la edad materna extrema, mujeres embarazadas negras e indígenas y niveles de educación más bajos. Conclusión: mayor prematuridad en situación de vulnerabilidad social, embarazos gemelares y de la Región Norte. Proporciones se mantuvieron estables, sin diferencias entre períodos.
Objective: to measure the prevalence of prematurity according to the Brazilian macro-regions and maternal characteristics over the past 11 years; to compare the proportions during the COVID-19 pandemic (2020-2021) with those of the historical series (2011-2019). Methods: this was an ecological study, with data from the Live Birth Information System; the prevalence was calculated according to year, macro-region and maternal characteristics; time series analysis was performed using Prais-Winsten regression model. Results: the prevalence of preterm birth in 2011-2021 was 11.1%, stable; the average in the pandemic period 11.3% (95%CI 11.2;11.4%) was similar to that of the base period 11.0% (95%CI 10.6;11.5%); the North region (11.6%) showed the highest proportion between 2011 and 2021; twin pregnancy (56.3%) and pregnant women who had 4-6 prenatal care visits (16.7%) showed an increasing trend (p-value < 0.001); the highest prevalence was observed for extremes of maternal age, pregnant women of Black race/skin color, indigenous women and those with lower level of education. Conclusion: preterm birth rates were highest for socially vulnerable pregnant women, twin pregnancies and in the North; stable prevalence, with no difference between periods.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant, Premature , Time Series Studies , Premature Birth/epidemiology , Brazil/epidemiology , COVID-19 , Obstetric Labor, PrematureABSTRACT
@#Support and education are vital for preemie moms to provide a comprehensive guide and ensure effective implementation of relevant information for premature baby care after NICU discharge. The present study aimed to determine the component of caregiving activities for premature babies. A six-stage methodological framework was used in guiding the review process recommended by Arksey and O’Malley (2005). The EBSCOhost Medical database, which included Medline, Psychology and Behavioural Sciences Collection, and Ovid, grey literature, reference list, and the Google Scholar search engine, was used for the search strategies. A total of 105 studies of English-language articles were tracked from the year 2000–2016. Selecting only full text and peer review resulting in ten studies and eight relevant documents. Nineteen themes were identified related to premature baby care activities. In conclusion, the themes revealed were best described as specific caregiving activities for premature babies valuable for mothers to organise post-discharge care. To engage, mothers should provide appropriate care to their premature babies as NICU babies are more fragile than normal newborn babies.
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@#Introduction: Proper nutrition for premature babies is vital for optimal growth. However, a lack of confidence and knowledge among parents causes them to search for online information which may sometimes be misleading or unreliable. The primary objective of this study is to develop a validated website as an educational tool for parents about nutrition for premature babies. Methods: This study was conducted by referring to the Waterfall Software Development Life Cycle (SDLC) model, which consists of five main stages. Stages one to three are related to the development of the website, namely, the requirements stage, design stage and implementation stage. This is then followed by a testing stage where 11 expert panels evaluated the content and face validity of the website. The final stage is the maintenance stage. Results: The website was developed with nine topics. The value of Item Content Validity Index (I-CVI) for every item exceeded the minimum value of I-CVI (0.78), the value of the content validity index by scale, average (S-CVI/Ave) is 0.98, and the content validity index by scale, universal agreement (S-CVI/UA) is 0.83. Both S-CVIs have exceeded the minimum value, which is 0.90 and 0.80 respectively. The value of Krippendorff's Alpha (Kalpha) for the overall section of face validity is 0.53, which does not achieve the minimum acceptable value of Kalpha (0.67). Conclusion: The content validation has high agreement among the expert panels. However, the interphase, layout, and design of the website need to be improvised.
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A preparação para a alta do bebê prematuro, que precisou ficar internado em uma Unidade de Terapia Intensiva Neonatal (UTI Neo) após o nascimento, é um processo complexo, permeado por diversos sentimentos e expectativas das mães. O objetivo do presente estudo foi investigar os sentimentos e as expectativas maternos no momento próximo à alta hospitalar de seus bebês nascidos prematuros. Participaram 42 mães, que responderam a uma entrevista estruturada quando o bebê estava a poucos dias de receber alta. Uma análise qualitativa revelou maior envolvimento das mães nos cuidados com o bebê em relação aos momentos anteriores da internação, sendo um período marcado por mais contato e proximidade entre a díade. Destaca-se a relevância do papel da equipe, incentivando esse envolvimento e sendo parte importante da transição para o cuidado materno. Esse momento também foi marcado por sentimentos diversos e contraditórios e pela expectativa materna de poder contar com a ajuda de outras pessoas da família nos cuidados em casa. Evidencia-se a importância de que a alta do bebê seja planejada desde o início da internação, considerando-se as especificidades emocionais de cada mãe.
Preparing for the premature baby's discharge, which was hospitalized in a Neonatal Intensive Care Unit (NICU) after birth, is a complex process, permeated by several maternal feelings and expectations. The objective of this study was to investigate maternal feelings and expectations in a moment near to their premature babies' hospital discharge. The participants were 42 mothers who answered a structured interview when the baby was about to be discharged. Qualitative analisys showed a greater maternal involvement in care for the baby when compared to previous moments of hospitalization, being that a moment of more closeness and proximity in the dyad. The role of hospital staff encouraging this involvement was highlighted, which was an important part of the transition to maternal care. This moment was also marked by various feelings and the maternal expectation of counting on the help from other relatives at home. It is important that baby's discharge is planned since the beggining of hospitalization, considering the emotional specificities of each mother.
La preparación para la descarga del bebé, que ha sido internado en la Unidad de Cuidados Intensivos Neonatales (UCI Neo) después del nacimiento, es un proceso complejo, permeado por diferentes sentimientos y expectativas de las madres. El objetivo de este estudio fue investigar los sentimientos y expectativas maternas en el momento cerca de la descarga de sus bebés prematuros. Participaron 42 madres, que respondieron a una entrevista estructurada cuando el bebé estaba a unos pocos días de la descarga. Un análisis cualitativo reveló una mayor participación de las madres en el cuidado del bebé en relación con los períodos anteriores de hospitalización y un período marcado por un mayor contacto y acercamiento entre la díada. Se destaca la importancia del papel del equipo en el fomento de esta participación y una parte importante de la transición al cuidado de la madre. Este momento también estuvo marcado por sentimientos maternos diversos y contradictorios y la expectativa materna de contar con la ayuda de otraspersonas de la familia en el cuidado en domicilio. Evidenciase la importancia de que la descarga del bebé estea planeada desde el comienzo de la hospitalización, teniendo en cuenta las características emocionales de cada madre.
Subject(s)
Humans , Female , Adult , Middle Aged , Patient Discharge , Intensive Care, Neonatal/psychology , Child Care/psychology , Infant, Premature/psychology , Parenting/psychology , Parturition , Emotions , Hospitalization , Intensive Care Units , Mother-Child Relations/psychology , MothersABSTRACT
Objective To explore the high risk factors of different degrees of premature infants with bronchopulmonary dysplasia (BPD) and to provide theoretical basises for the clinical prevention of BPD.Methods The clinical datas of 64 cases patients with BPD who were diagnosed and hospitalized in Neonatology Department of Affiliated Hospital of Qingdao University from June in 2009 to March in 2016 were retrospective analyzed,from several aspects to analyze the BPD's high risk factors,such as the mother's factors,the perinatal factors,treatments after birth and complications.Results There were 27 moderate and mild cases,19 moderate cases and 18 severe cases in children who were diagnosed BPD;different degrees of BPD patients in gender,5 minute's apgar score,the repeated application of PS,long time of mechanical ventilation,high concentration of oxygen inhalation,neonatal pneumonia,blood transfusion and neonatal anemia's differences were significant in the severity of BPD difference (P =0.003,0.033,0.006,0.002,0.001,0.000,0.001,0.001,0.036,0.004).Conclusion Strengthen resuscitation in delivery room,shorten the mechanical ventilation time and reduce the high concentration oxygen inhalation,prevent and reduce the infection after delivery,reduce latrogenic blood loss and the number of blood transfusion are important measures to alleviate the severity of BPD.
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Objective To analyze the clinical value of gastric bacterial cultivation in the early diagnosis of bacterial infection in preterm infants.Methods 174 preterm with risk perinatal factors of infection in NICU of Chang’an Hospital from January 2013 to December 2014 were collected,they were given the gastric juice cultivation checking in 1 hour after birth before eat-ing,watering and giving medicine.According to the clinical symptoms and laboratory test results,they were divided into the infected group and non-infected group.Their Gastric cultivation inspection was compared and analyzed in two groups.Results The positive rate of bacterial culture of gastric fluid was 40.8% (71/174),and located in the top four is Escherichia coli 30.99% (22/71),coagulase-negative staphylococci 21.13%(15/71),Staphylococcus aureus 14.08%(10/71)and group B streptococcus 8.45% (6/71).There was relation between premature infants with bacterial culture positive and meconium stained amniotic fluid,maternal infection during pregnancy,premature rupture of membranes,but not with gestational hyper-tension,fever unrelated to the mother giving birth.Conclusion There was high positive rate of gastric juice bacterial culture with a significant correlation of early onset infection.
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Este estudo objetiva compreender as condições emocionais de uma mãe após o nascimento e internação de uma bebê prematura de muito baixo peso. O trabalho tem enfoque qualitativo e utiliza como método o estudo de caso instrumental. É analisada, sob a perspectiva de Winnicott, a vivência de uma mãe que já havia perdido dois bebês durante as gestações e um prematuro. A análise permite compreender a dinâmica emocional e a fragilidade egoica materna. É possível ampliar o olhar sobre a prematuridade e tecer considerações a respeito das possibilidades de ajuda oferecida às mães de bebês prematuros...
This study aimed to comprehend the emotional conditions of a mother, after the birth and hospitalization of a very low weight preterm child. The work had a qualitative perspective and used as method the instrumental case study. It was analyzed, under Winnicott's approach, the experience of a mother who had already lost two babies during pregnancy and a preterm child. The analysis allowed understanding the emotional dynamic and the ego fragility of this mother. It was possible to broaden perspectives on preterm delivery and make some considerations regarding the possibilities of help offered to mothers of premature babies...
Este estudio trató de comprender el estado emocional de una madre después del nacimiento e internación de un bebé prematuro de muy bajo peso. El trabajo tuvo un enfoque cualitativo y utilizó como método el estudio de caso instrumental. la vivencia de la madre, que ya había perdido dos bebés durante las gestaciones y uno prematuro, se analizó con la perspectiva de Winnicott. El análisis permitió comprender la dinámica emocional y la fragilidad egoica de esta madre. fue posible ampliar la mirada sobre la prematuridad y elaborar consideraciones con respecto a las posibilidades de ayuda a las madres de bebés prematuros...
Subject(s)
Humans , Hospitalization , Infant, Premature , Mother-Child Relations , Mothers/psychology , PsychoanalysisABSTRACT
O objetivo deste trabalho é problematizar a clínica e o corpo no hospital, especificamente em uma Unidade de Terapia Intensiva Neonatal, a partir da experiência da autora como psicóloga nesse contexto. Utilizando uma metodologia cartográfica que resgata um plano de sensibilidades, frequentemente higienizadas no hospital, percorremos as singularidades dos encontros clínicos, atravessados pelos agenciamentos das instituições hospital e família. Com isso, evidenciamos as marcas homogeneizantes e apacientadoras dos encontros com o bebê prematuro que ali se encontra, mas também percebemos linhas de fuga a esses modos dominantes que abrem novas possibilidades de cuidar. Ao nos interrogarmos sobre a potência do corpo e da clínica, fomos percorrendo e afirmando uma clínica minúscula, que se compõe nos encontros singulares e coloca em cena outra ética intensiva da vida.
The aim of this study was to raise questions regarding clinical care and the body in hospital, and specifically in a neonatal intensive care unit, based on the author's experience as a psychologist in this context. Using cartographic methodology that retrieved the plane of sensitivities, which are often cleansed in hospitals, we explored the singularities of clinical encounters, with the intermediation of hospital and family institutions. Through this, we showed the homogenizing and patient-forming characteristics of encounters with premature babies present there. However, we also could see lines of flight from these dominant ways, which might open new care possibilities. In ask ourselves about the power of the body and clinical care, we went on exploring, with affirmation of clinical care for tiny babies, built through singular encounters, which brings in another intensive ethical paradigm for life.
El objetivo de ese trabajo es problematizar la clínica y el cuerpo en una Unidad de Cuidados Intensivos Neo-natal, desde la experiencia como psicóloga en este contexto. A través de una metodología cartográfica que rescata un plano de sensibilidades, a menudo higienizadas en el hospital, buscamos recorrer las singularidades de los encuentros clínicos, atravesados por las instituciones hospital y familia. Así, encontramos las marcas homogeneizantes de los encuentros con el bebé prematuro que ahí se encuentra. Pero, pudimos ver las líneas de fuga a esos modos dominantes que van abriendo nuevas posibilidades de cuidar. Cuando nos preguntamos sobre la potencia del cuerpo y de la clínica, fuimos recorriendo y afirmando una clínica minúscula que se compone en los encuentros singulares y pone en escena otra ética intensiva de la vida.
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Objective To investigate the therapeutic effect and nursing ways of pulmonary surfactant in premature babies with respiratory distress syndrome. Methods From July 2008 to January 2011,63 cases of premature babies with respiratory distress syndrome were admitted to our department, pulmonary surfactant was dripped through trachea into these patients, the treatment effect after medication was observed. Results Among these premature babies, one case died of respiratory failure, one case died from pulmonary hemorrhage, sixty-one cases were cured, the cure rate was 96.8%. After treatment, the arterial blood pH, partial pressure of oxygen(PaO2) and oxygen saturation(SaO2) of the 61 patients was significantly higher than before treatment, the arterial blood partial pressure of carbon dioxide (PaCO2)、 total carbon dioxide (TCO2)、actual bicarbonate (AB)was significantly lower than before treatment. Conclusions Pulmonary surfactant combined with appropriate nursing ways is able to cure premature babies with respiratory distress syndrome effectively.
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Although candidal infections are common in the neonatal period, less than 100 cases of Congenital Cutaneous Candidiais (CCC) have been reported in the English literature. CCC appears to be acquired in the uterus by the ascension of organisms from an infected vagina into the uterine cavity. In this report, we describe a premature baby with CCC. At 6 months, his mother had a vaginal candidial infection which was treated. Her pregnancy terminated in preterm labor at 32 weeks. Desquamated patches that involved the trunk and extremities were noted at birth. The possibility of CCC was considered and numerous psedohyphae and spores were seen in the lesions by KOH microscopic examination. The skin lesions cleared completely after 2 weeks of topical clotrimazole cream.
Subject(s)
Female , Humans , Pregnancy , Candidiasis, Cutaneous , Chlormequat , Clotrimazole , Extremities , Mothers , Obstetric Labor, Premature , Parturition , Skin , Spores , Uterus , VaginaABSTRACT
PURPOSE: This study tries to explore mothers' stress patterns and the related factors influencing mothers' stress over time after giving birth to premature babies. METHOD: Eighty four mothers who had given birth to premature babies were selected from Hospitals in B city. Data was collected using a self-reporting questionnaire that the mothers' stress level. RESULT: The mothers' stress after giving birth to premature babies gradually diminished and the stress pattern of mothers changed over time. Mother's age, occupation, income level, gestational period of the measures baby, weight at birth, nutrition type, lactation mode, number of complications, and existence or non-existence of an operation were analyzed as the factors that affected the mother's stress. CONCLUSION: The stress pattern of mothers giving birth to premature babies changed overtime. Based on the study results, it is considered that the nursing intervention programs should be developed in order to reduce the stress of premature baby's mothers with time elapse.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , Infant, Premature , Mothers/psychology , Premature Birth/psychology , Stress, Psychological/etiology , Time FactorsABSTRACT
We report 3 cases of unusual cutis marmorata telangiectatica congenita (CMTC). The ages of the first two cases of CMTC were premature babies, born at intrauterine pregnancy of 31 weeks and 34 weeks. the other patient was a 45-year old female. Compared to the age of other cases reported in the literature our patients ages are unusual. It is not surprising that the first two cases of premature babies had typical signs because CMTC is a congenital disorder, usually seen at birth, but the fact that the skin lesion of CMTC appeared already in the early third trimester may provide some clues to the pathogenesis of CMTC. The third case seems to be very rare because most reported cases show that the skin lesion usually disappear gradually over a period of months to years. The site and size of the lesion in the last case was told to have been fixed for 45 years without any change.
Subject(s)
Female , Humans , Pregnancy , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Parturition , Pregnancy Trimester, Third , SkinABSTRACT
The author has studied on the differences in blood pictures, especially the differences of blood pictures in capillary blood and venous blood, in 25 premature babies and 50 term babies from birth to 7 days of age sequentially during the period of 6 monts from April 1980 to Sept. 1980. The results are summarized as follws; 1. As comparing blood pictures with term babies, premature babies showed somewhat lower values in erythrocyte, hemoglobin, hematocrit. MCV, MCH, leucocyte and platelet but somewhat higher values in reticulocyte and MCHC. 2. As comparing blood pictures with the venous blood, the capillary blood showed significantly higher values in erythrocyte, hemoglobin and hematocrit during the neonatal period in both premature babies and term babies, but showed somewhat lower values in MCV, MCH, MCHC, and platelet. 3. According to the time of clamping the umbilical cord after birth, there were significant differences of blood pictures between early and late clamping of the umbilical cord. 4. The highest mean erythrocyte counts in both term babies and premaature babies were 5,896,000/cub.mm and 5,542,000/cub.mm at 3-6 hours after birth. Those values were gradually decreased to 5,104,000/cub.mm and 4,753,000/cub.mm on the 6th-7the day of life. 5. The highest average hemoglobin levels in both term babies and premature babies were 21.1gm/dl and 19.5gm/dl at 3-6 hours after birth. Those values were gradually decreased to 18.1gm/dl and 17.1gm/dl on the 6th-7th day of life. 6. The mean values of hematocrit in both term babies and premature babies were higest, 64.5% and 59.9% at 3-6 hours after birth. Those values were gradually decreased to 54.8% and 50.2% on the 6th-7the of life. 7. The average total serum protein levels in both term babies and premature babies were 5.76gm/dl and 5.22gm/dl at birth. Those values were increased to 6.45gm/dl and 5.74gm/dl at 3- hours after birth. 8. The average MCV in both term babies and premature babies showed highest values, 114.2fl and 110.1fl at birth. Those values were gradually decreased to 107.0fl and 103.4fl on the 6th-7th day of life. 9. The average MCH in both term babies and premature babies showed highest values, 36.8pg and 35.3pg at birth. Those values were gradually decreased to 107.0fl and 103.4fl on the 6th-7th day of life. 10. The average MCHC in both term babies and premature babies showed constant levels, 31.3-32.0% and 32.2-33.1% from birth to 7the day of life. 11. The average platelet counts in both term babies and premature babies were 243,000/cub.mm and 229,000/cub.mm during the first 4 days of life. Those values were gradually increased to 283,000/cub.mm and 253,000/cub.mm on the 6th-7the day of life. 12. The highest reticulocyte counts in both term babies and premature babies were 3.1% and 3.6% at the age of 3-6 hours. Those values were rapidly dropped down from 4th day to 7th day of life, decreasing from 1.7% and 1.9% to 1.0% and 1.3%. 13. The highest llecucyte counts in both term babies and premature babies were 25,794/cub.mm and 23,363/cub.mm at the age of 3-6 hours. Both values were gradually decreased to 13,213/cub.mm and 11,870/cub.mm on the 6th-7th day of life.