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1.
Chinese Journal of Contemporary Pediatrics ; (12): 18-24, 2023.
Article in Chinese | WPRIM | ID: wpr-971034

ABSTRACT

OBJECTIVES@#To identify the perinatal risk factors for the occurrence of singleton apparently stillborn infants.@*METHODS@#This was a case-control study. A total of 154 singleton neonates with gestational age ≥28 weeks and Apgar score of 0-1 who were subsequently successfully resuscitated in the Obstetrics and Gynecology Hospital of Fudan University from January 2006 to December 2015 were enrolled as the case group (apparently stillborn group). A total of 616 singleton infants born from January 2006 to December 2015 (1-minute Apgar score >1) were randomly selected in a 1:4 ratio as the control group. Univariate analysis and multivariate logistic regression were used to analyze the perinatal risk factors for the occurrence of apparently stillborn infants.@*RESULTS@#The gestational age and birth weight in the apparently stillborn group were significantly lower than those in the control group (P<0.05). The incidences of fetal hydrops, cord prolapse, grade III meconium-stained amniotic fluid, placental abruption, breech presentation, severe pre-eclampsia, maternal general anesthesia at delivery, abnormal antenatal fetal heart monitoring and decreased fetal movement were significantly higher in the apparently stillborn group than those in the control group (P<0.05). The multivariate logistic analysis showed that the mother had general anesthesia at delivery (OR=34.520), decreased antenatal fetal movement (OR=28.168),placental abruption (OR=15.641), grade III meconium-stained amniotic fluid (OR=6.365), abnormal antenatal fetal heart monitoring (OR=5.739), and breech presentation (OR=2.614) were risk factors for the occurrence of apparently stillborn infants (P<0.05), while higher gestational age was a protective factor (OR=0.686, P<0.05).@*CONCLUSIONS@#Attention needs to be paid to mothers with abnormal prenatal fetal heart monitoring, decreased fetal movement, preterm labor, placental abruption, breech presentation, grade III meconium-stained amniotic fluid, and general anesthesia. Preparations for resuscitation should be done to rescue apparently stillborn infants.


Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Abruptio Placentae/epidemiology , Apgar Score , Breech Presentation , Case-Control Studies , Placenta , Pregnancy Complications/epidemiology , Risk Factors , Stillbirth
2.
Psicol. ciênc. prof ; 43: e255195, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529228

ABSTRACT

A pandemia de covid-19 provocou intensas mudanças no contexto do cuidado neonatal, exigindo dos profissionais de saúde a reformulação de práticas e o desenvolvimento de novas estratégias para a manutenção da atenção integral e humanizada ao recém-nascido. O objetivo deste artigo é relatar a atuação da Psicologia nas Unidades Neonatais de um hospital público de Fortaleza (CE), Brasil, durante o período de distanciamento físico da pandemia de covid-19. Trata-se de estudo descritivo, do tipo relato de experiência, que ocorreu no período de março a agosto de 2020. No contexto pandêmico, o serviço de Psicologia desenvolveu novas condutas assistenciais para atender às demandas emergentes do momento, como: atendimento remoto; registro e envio on-line de imagens do recém-nascido a seus familiares; visitas virtuais; e reprodução de mensagens de áudio da família para o neonato. Apesar dos desafios encontrados, as ações contribuíram para a manutenção do cuidado centrado no recém-nascido e sua família, o que demonstra a potencialidade do fazer psicológico.(AU)


The COVID-19 pandemic brought intense changes to neonatal care and required health professionals to reformulate practices and develop new strategies to ensure comprehensive and humanized care for newborn. This study aims to report the experience of the Psychology Service in the Neonatal Units of a public hospital in Fortaleza, in the state of Ceará, Brazil, during the social distancing period of the COVID-19 pandemic. This descriptive experience report study was conducted from March to August 2020. During the pandemic, the Psychology Service developed new care practices to meet the emerging demands of that moment, such as remote care, recordings and online submission of newborns' pictures and video images for their family, virtual tours, and reproduction of family audio messages for the newborns. Despite the challenges, the actions contributed to the maintenance of a care that is centered on the newborns and their families, which shows the potential of psychological practices.(AU)


La pandemia de la COVID-19 ha traído cambios intensos en el contexto de la atención neonatal, que requieren de los profesionales de la salud una reformulación de sus prácticas y el desarrollo de nuevas estrategias para asegurar una atención integral y humanizada al recién nacido. El objetivo de este artículo es reportar la experiencia del Servicio de Psicología en las Unidades Neonatales de un hospital público de Fortaleza, en Ceará, Brasil, durante el periodo de distanciamiento físico en la pandemia de la COVID-19. Se trata de un estudio descriptivo, un reporte de experiencia, que se llevó a cabo de marzo a agosto de 2020. En el contexto pandémico, el servicio de Psicología desarrolló nuevas conductas asistenciales para atender a las demandas emergentes del momento, tales como: atención remota; grabación y envío em línea de imágenes del recién nacido; visitas virtuales; y reproducción de mensajes de audio de la familia para el recién nacido. A pesar de los desafíos encontrados, las acciones contribuyeron al mantenimiento de la atención centrada en el recién nacido y su familia, lo que demuestra el potencial de la práctica psicológica.(AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Psychology , Teleworking , COVID-19 , Neonatology , Anxiety , Oxygen Inhalation Therapy , Apgar Score , Patient Care Team , Patient Discharge , Pediatrics , Perinatology , Phototherapy , Prenatal Care , Quality of Health Care , Respiration, Artificial , Skilled Nursing Facilities , Survival , Congenital Abnormalities , Unconscious, Psychology , Visitors to Patients , Obstetrics and Gynecology Department, Hospital , Health Care Levels , Brazil , Breast Feeding , Case Reports , Infant, Newborn , Infant, Premature , Cardiotocography , Health Behavior , Intensive Care Units, Pediatric , Intensive Care Units, Neonatal , Child Development , Child Health Services , Infant Mortality , Maternal Mortality , Cross Infection , Risk , Probability , Vital Statistics , Health Status Indicators , Life Expectancy , Women's Health , Neonatal Screening , Nursing , Enteral Nutrition , Long-Term Care , Parenteral Nutrition , Pregnancy, High-Risk , Pliability , Comprehensive Health Care , Low Cost Technology , Pregnancy Rate , Life , Creativity , Critical Care , Affect , Crying , Humanizing Delivery , Uncertainty , Pregnant Women , Continuous Positive Airway Pressure , Disease Prevention , Humanization of Assistance , User Embracement , Information Technology , Child Nutrition , Perinatal Mortality , Resilience, Psychological , Fear , Feeding Methods , Fetal Monitoring , Patient Handoff , Microbiota , Integrality in Health , Ambulatory Care , Neurodevelopmental Disorders , Maternal Health , Neonatal Sepsis , Pediatric Emergency Medicine , Psychosocial Support Systems , Survivorship , Mental Status and Dementia Tests , Access to Essential Medicines and Health Technologies , Family Support , Gynecology , Hospitalization , Hospitals, Maternity , Hyperbilirubinemia , Hypothermia , Immune System , Incubators , Infant, Newborn, Diseases , Length of Stay , Life Change Events , Love , Maternal Behavior , Maternal Welfare , Medicine , Methods , Nervous System Diseases , Object Attachment , Obstetrics
3.
Rev. cienc. cuidad ; 20(1): 22-32, 20230101.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1435210

ABSTRACT

Introducción: El embarazo en la adolescencia tiende a presentar repercusiones personales, sociales, educativas y psicológicas en la madre y en el hijo. Es por ello por lo que el apoyo de la familia y su funcionalidad resultan cruciales. Objetivo: Determinar el nivel de funcionalidad familiar existente en las familias de las adolescentes gestantes asistentes a controles prenatales en tres instituciones de salud de Cartagena-Colombia durante 2021. Materiales y Métodos: Estudio descriptivo, de corte transversal, y asociación. La población estuvo constituida por 780 adolescentes gestantes que asisten a controles prenatales en dos instituciones. Se determinó una muestra de 185 adolescentes gestantes, seleccionadas mediante muestreo probabilístico. Fue aplicado instrumento sociodemográfico y APGAR familiar. Resultados: Las gestantes participaron de la institución A (50,81%) y de la institución B (44,32%), se trató de adolescentes bachilleres (58,92%), que conviven en unión libre (51,35%), en familias nucleares de origen (32,97%) y sus familias devengan ingresos entre 1 ­ 2 salarios mínimos (48,11%). El embarazo actual no fue planeado, y a los controles prenatales asisten con la mamá (31,35%), la pareja (27,57%) o solas (22,16%). La funcionalidad normal fue la más frecuente (99,46%), y se presentó asociación (p ≤ 0,05) con las instituciones, con la tipología familiar de naturaleza monoparental conformada y con el acompañamiento a los controles prenatales. Conclusión: Se determinó un nivel de funcionalidad familiar normal en las familias de las adolescentes gestantes asistentes a controles prenatales en dos instituciones de salud de Cartagena.


Introduction: Pregnancy in adolescence tends to have personal, social, educational, and psychological repercussions on the mother and child. That is why the support of the family, and its functionality are crucial. Objective: To determine the level of family functionality existing in the families of pregnant adolescents attending prenatal check-ups in three health institutions in Cartagena-Colombia during 2021. Materials and Methods: Descriptive, cross-sectional, and association study. The population consisted of 780 pregnant adolescents who attend prenatal check-ups in two institutions. A sample of 185 pregnant adolescents, selected by probabilistic sampling, was estimated. Sociodemographic instrument and family APGAR were applied. Results: Pregnant women participated in institution A (50.81%) and institution B (44.32%), they were high school adolescents (58.92%), who live together in a free union (51.35%), in nuclear families of origin (32.97%) and their families earn between 1 ­ 2 minimum wages (48.11%). The current pregnancy was not planned, and prenatal check-ups are attended by the mother (31.35%), the couple (27.57%) or alone (22.16%). Normal functionality was the most frequent (99.46%) and was correlated (p ≤ 0.05) with the institutions, with the family typology of a single-parent nature formed and with the accompaniment to prenatal controls. Conclusion: A normal level of family functionality was determined in the families of pregnant adolescents attending prenatal check-ups in two health institutions in Cartagena.


Introdução: A gravidez na adolescência tende a ter repercussões pessoais, sociais, educacionais e psicológicas sobre a mãe e o filho. É por isso que o apoio da família e sua funcionalidade são cruciais. Objetivo: Determinar o nível de funcionalidade familiar existente nas famílias de adolescentes gestantes que participam de check-ups pré-natal em dois instituições de saúde em Cartagena-Colômbia durante 2021. Materiais e métodos: Estudo descritivo, transversal e associacao de estudo. A população era composta por 780 adolescentes gestantes que frequentam o pré-natal em dois instituições. Foi estimada uma amostra de 185 adolescentes gestantes, selecionadas por amostragem probabilística. Foram aplicados instrumentos sociodemográficos e APGAR familiar. Resultados: Gestantes participaram da instituição A (50,81%) e da instituição B (44,32%), eram adolescentes do ensino médio (58,92%), que vivem juntas em união gratuita (51,35%), em famílias nucleares de origem (32,97%) e suas famílias ganham entre 1 e 2 salários-mínimos (48,11%). A gestação atual não foi planejada, e os check-ups pré-natal são atendidos pela mãe (31,35%), pelo casal (27,57%) ou sozinho(22,16%). A funcionalidade normal foi a mais frequente (99,46%), e foi correlacionada (p ≤ 0,05) com as instituições, com a tipologia familiar de natureza monoparental conformada e com o acompanhamento aos controles pré-natais. Conclusão: Foi determinado um nível normal de funcionalidade familiar nas famílias de adolescentes gestantes que frequentam oscheck-ups do pré-natal em dois instituições de saúde de Cartagena.


Subject(s)
Pregnancy in Adolescence , Apgar Score , Prenatal Care , Family
4.
J. Health NPEPS ; 7(2)jul - dez, 2022.
Article in Portuguese | LILACS, BDENF, ColecionaSUS | ID: biblio-1416503

ABSTRACT

Objetivo:avaliar os fatores associados ao baixo Apgar em recém-nascidos de Angola. Método:estudo analíticoe transversal, quali-quantitativo, em umHospital Geral de Luanda, Angola, entre março e maio de 2021. Realizou-se entrevistas em sala de observação e consulta aos prontuários das parturientes. Os dados foram analisados pelo teste qui-quadrado (X2) e regressão logística. Resultados:prevaleceu parturientes entre 19-35 anos (70,0%), 7º-9º ano (57,5%), multíparas (75%), multigestas (75,0%), sem histórico de aborto (72,5%), idade gestacional de 40 semanas (60,0%), usuárias de bebidas alcoólicas (77,5%), baixa frequência de consultas pré-natais (52,5%), com parto natural (82,5%) e recém-nascidos com peso normal (52,5%). Mulheres de região periurbana [OR:6,85 (95% CI:0.65-71,2), p=0,108] e rural [OR:4,47 (95% CI:0.47-48,4), p=0,184] apresentaram maior chance de terem recém-nascidos com baixo Apgar, assim como as usuárias de álcool [OR:3,28 (95% CI:0,58-18,3), p=0,176] e recém-nascidos que nasceram com peso normal [OR:1,75 (95% CI:0,49­6,22), p=0,387]. Não houve associação estatística entre os dados sociodemográficos e maternos. Conclusão:a faixa etária, local de residência, consumo de álcool materno e peso do recém-nascido podem implicar em baixo Apgar.


Objective: to evaluate the factors associated with low Apgar in newborns in Angola. Method:analytical and cross-sectional, quali-quantitative study, in a General Hospital in Luanda, Angola, between March and May 2021. Interviews were carried out in an observation room and consultation of the parturients' medical records. Data were analyzed using the chi-square test (X2) and logistic regression.Results: pregnant women aged 19-35 years (70.0%), 7th-9th year(57.5%), multiparous (75%), multiparous (75.0%), without a history of abortion (72.5%), prevailed. gestational age of 40 weeks (60.0%), users of alcoholic beverages (77.5%), low frequency of prenatal consultations (52.5%), with natural childbirth (82.5%) and newborns with normal weight (52.5%). Women from peri-urban regions [OR:6.85 (95% CI:0.65-71.2), p=0.108] and rural [OR:4.47 (95% CI:0.47-48.4), p=0.184] were more likely to have low Apgar newborns, as well as alcohol users [OR:3.28 (95% CI:0.58-18.3), p=0.176] and newborns who were born with normal [OR:1.75 (95% CI:0.49­6.22), p=0.387]. There was no statistical association between sociodemographic and maternal data.Conclusion: age group, place of residence, maternal alcohol consumption and newborn weight may imply low Apgar.


Objetivo: evaluar los factores asociados al Apgar bajo en recién nacidos en Angola.Método: estudio analítico y transversal, cuali-cuantitativo, en un Hospital General de Luanda, Angola, entre marzo y mayo de 2021. Se realizaron entrevistas en sala de observación y consulta de las historias clínicas de las parturientas. Los datos se analizaron mediante la prueba de chi-cuadrado (X2) y regresión logística. Resultados: gestantes de 19 a 35 años (70,0%), de 7° a 9° año (57,5%), multíparas (75%), multíparas (75,0%), sin antecedente de aborto (72,5%), predominó la edad gestacional de 40 semanas (60,0%), usuarias de bebidas alcohólicas (77,5%), baja frecuencia de consultas prenatales (52,5%), con parto natural (82,5%) y recién nacidos con normopeso (52,5%). Las mujeres de regiones periurbanas [OR:6,85 (IC 95%:0,65-71,2), p=0,108] y rurales [OR:4,47 (IC 95%:0,47-48,4), p=0,184] tenían más probabilidades de tener bajo Recién nacidos Apgar, así como consumidores de alcohol [OR:3,28 (IC 95%:0,58-18,3), p=0,176] y recién nacidos que nacieron con normalidad [OR:1,75 (IC 95%:0,49-6,22), p=0,387]. No hubo asociación estadística entre datos sociodemográficos y maternos. Conclusión: el grupo de edad, el lugar de residencia, el consumo materno de alcohol y el peso del recién nacido pueden implicar un Apgar bajo.


Subject(s)
Apgar Score , Infant, Newborn , Postpartum Period , Hospitals, Maternity , Angola
5.
Rev. ecuat. pediatr ; 23(3): 192-200, 12 de Diciembre del 2022.
Article in Spanish | LILACS | ID: biblio-1411238

ABSTRACT

Introducción: La sepsis neonatal temprana se describe como un síndrome clínico que se caracteriza por signos y síntomas asociados a infección sistémica, se presenta en las primeras 72 horas posterior al nacimiento. El objetivo del presente estudio fue determinar el perfil clínico ­ epidemiológico de la sepsis neonatal temprana en una unidad de cuidados intensivos neonatales de un centro de referencia regional en Guayaquil-Ecuador. Métodos: El presente estudio observacional, realizado en el Hospital "Teodoro Maldonado Carbo" de enero del 2017 al diciembre del 2020 incluyó neonatos con sepsis neonatal temprana con muestra no probabilística. Las variables: edad, edad gestacional, sexo, vía de infección, presencia de infecciones de del tracto urinario, peso, genopatías, Apgar al 1er minuto, escala de Silverman, etapas clínicas, llenado capilar, gasto urinario, variables clínicas, de laboratorio, hemocultivo, organismo casal. El análisis es univariado, descriptivo con frecuencias y porcentajes. Resultados: Se incluyeron 278 pacientes con edad gestacio-nal promedio de 33 semanas, fueron 59.4% hombres. Los factores de riesgo materno fueron a IVU en el embarazo e infección transplacentaria. Entre los factores asociados al neonato son el bajo peso (56%), prematuridad (67%). La clínica más frecuente fue eutermia y taquipnea (54%). En el perfil de laboratorio la neu-tropenia predominó (49%), mientras que los agentes causales identificados Staphylococcus hominis 7%, Escherichia coli 4.3% y Klebsiella pneumoniae 4%. Conclusión: Se determinó la relación directa entre las características epidemiológicas y las etapas clínicas de la sepsis neonatal.


Introduction: Early neonatal sepsis is a clinical syndrome characterized by signs and symptoms associated with systemic infection; it occurs in the first 72 hours after birth. This study aimed to determine the clinical-epidemiological profile of early neonatal sepsis in a neonatal intensive care unit of a regional reference center in Guayaquil, Ecuador. Methods: The present observational study, carried out at the "Teodoro Maldonado Carbo" Hospital from January 2017 to December 2020, included neonates with early neonatal sepsis with a nonprobabilistic sample. The variables were age, gestational age, sex, route of infection, presence of urinary tract infections, weight, genopathies, Apgar at 1 minute, Silverman scale, clinical stages, capillary refill, urinary output, clinical and laboratory variables, haem culture, and causative organism. The analysis is univariate and descriptive with frequencies and percentages. Results: A total of 278 patients with a mean gestational age of 33 weeks were included, and 59.4% were men. Maternal risk factors were UTI in pregnancy and transplacental infection. Among the factors associated with the newborn were low weight (56%) and prematurity (67%). The most frequent symptoms were euthermia and tachypnea (54%). In the laboratory profile, neutropenia predominated (49%), while the causative agents were Staphylococcus hominis (7%), Escherichia coli (4.3%), and Klebsiella pneumoniae (4%). Conclusion: The direct relationship between the epidemiological characteristics and the clinical stages of neonatal sepsis was determined.


Subject(s)
Humans , Infant, Newborn , Risk Factors , Neonatal Sepsis , Apgar Score , Epidemiology
6.
Femina ; 50(12): 751-761, dez. 31, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1414430

ABSTRACT

Objetivo: Caracterizar a população das gestantes em diferentes faixas etárias; avaliar desfechos maternos e neonatais em pacientes com idade materna avançada; determinar a faixa etária a partir da qual os desfechos adversos foram mais prevalentes. Métodos: Parturientes atendidas no Hospital do Servidor Público Estadual de São Paulo entre junho/2019 e maio/2020 foram divididas em três grupos ­ 20 a 34 anos; 35 a 39 anos; 40 anos ou mais ­ e analisadas quanto a diversas variáveis. Resultados: Entre as gestantes do Serviço, 44,2% tinham idade materna avançada. A amostra foi composta por 927 pacientes, a maioria com relacionamento conjugal estável (75,2%) e ensino de nível superior (74,7%). Independentemente do grupo etário, foram observados elevados índices de obesidade (25,9%), sobrepeso (39,7%) e cesariana (76,4%). A frequência de iteratividade, diabetes gestacional e doença hipertensiva específica da gestação foi maior a partir dos 35 anos, e a frequência de hipertensão arterial crônica foi maior a partir dos 40 anos. Neonatos de pacientes com 40 anos ou mais tiveram maiores índices de baixo peso ao nascer, óbito neonatal, Apgar de quinto minuto < 7 e necessidade de reanimação neonatal. Conclusão: Pacientes com idade materna avançada representaram porcentagem expressiva da população e tiveram maior frequência de desfechos adversos. Complicações obstétricas foram mais prevalentes a partir dos 35 anos, com destaque para diabetes gestacional e distúrbios hipertensivos. Resultados neonatais desfavoráveis, como baixo peso ao nascer e óbito neonatal, foram mais prevalentes a partir de 40 anos.


Objective: Featuring the population of pregnant women in different age groups; assessing maternal and neonatal outcomes in patients at advanced maternal age; determining the threshold age for the potential prevalence of adverse outcomes. Methods: Women in labor assisted at Hospital do Servidor Público Estadual de São Paulo between June/2019 and May/2020 were divided into three age groups ­ 20 to 34 years; 35 to 39 years; over 40 years ­, who were assessed for several variables. Results: 44.2% of pregnant women in this Service were at advanced maternal age. The sample counted on 927 patients, most of them declared stable marital relationships (75.2%) and College degree (74,7%). High obesity levels (25.9%), overweight (39.7%) and cesarean delivery (76.4%) were observed, regardless of age group. Maternal request was the main indication for cesarean surgery. Iteration frequency, gestational diabetes and pregnancy-specific hypertensive disease was higher from the age of 35 years, on. Chronical high blood pressure was higher in the age group over 40 years. Newborns from patients older than over 40 years presented higher low weight at birth index, neonatal death, 5th minute Apgar score < 7 and the need of neonatal resuscitation. Conclusion: Patients at advanced maternal age recorded higher obstetric adversity frequency in the age group over 35 years, with emphasis on gestational diabetes and high blood pressure. Unfavorable neonatal outcomes related to low weight at birth and neonatal death were more prevalent in the age group over 40 years.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications/epidemiology , Diabetes, Gestational/epidemiology , Pregnant Women , Maternal Health , Hypertension/epidemiology , Obesity/epidemiology , Apgar Score , Prenatal Care , Comorbidity , Retrospective Studies , Maternal Age , Sociodemographic Factors , Midwifery
7.
Niger. j. paediatr ; 49(3): 261-265, 2022. tables
Article in English | AIM | ID: biblio-1399083

ABSTRACT

In the absence of acute phase reaction, ferritin concentration has been used as a standard measurement of iron stores. Low birth weight babies are at risk of developing iron lack because ferritin concentration at birth is influenced by duration of gestation, maternal iron status and conditions altering maternal­foetal iron exchange. Aim: The aim of this study was to determine the ferritin concentrations of low birth weight babies in comparison with that of normal birth weight babies. Materials and methods: Fortyfour normal birth weight (NBW) babies and 40 low birth weight (LBW) babies were recruited for the study. About 1.0ml of venous blood was drawn aseptically from each subject into a micro EDTA tube, centrifuged at 5000rpm for 5 minutes, the plasma separated into cryotubes and stored at-20oC until ready for quantitative determination of ferritin concentrations using direct immunoenzymatic colorimetric method.Data obtained was analysed statistically using the Statistical Package for Social Sciences (SPSS,version 23, Chicago, IL, USA). Results: Gestational age correlated positively with ferritin concentrations in LBW neonates (p<0.05)while APGAR score correlatepositively with ferritin concentrations in normal birth weight babies (r=0.398; p<0.05). Thoug not statistically significant (p=0.214), median values for ferritin concentrations were 188.5µg/ dl and 373µg/dl for LBW and NBW neonates respectively. Conclusion: Gestational age correlated positively with ferritin concentrations in LBW neonates


Subject(s)
Humans , Apgar Score , Apoferritins , Infant, Low Birth Weight , Infant, Small for Gestational Age , Gestational Age
8.
Femina ; 50(5): 290-295, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1380707

ABSTRACT

Objetivo: Avaliar as indicações de cesárea por sofrimento fetal (SF), pelo escore de Apgar, em um hospital público. Métodos: Estudo de corte transversal e retrospectivo que incluiu todos os partos realizados no período de estudo. A análise estatística foi realizada no software IBM SPSS Statistics v.22 com teste do qui-quadrado de Pearson para o cálculo do p-valor. A estimativa de risco foi definida pela razão de chances comum de Mantel-Haenszel, com cálculo de odds ratio (OR), intervalo de confiança de 95% (IC95%) e limite de significância de 95% (p < 0,05). Resultados: Dos 2.205 partos, 1.084 (49,1%) foram cesáreas e 1.121 (50,9%), partos vaginais. Escore de Apgar < 7 no primeiro minuto foi evidenciado em 5,9% do total de partos. A diferença entre os escores de Apgar no primeiro minuto entre os dois tipos de parto foi estatisticamente significante (p < 0,05), e esses recém-nascidos (RNs) tiveram a chance 1,4 vez maior de Apgar < 7 nas cesáreas em relação ao parto vaginal (OR: 1,4; IC95%: 1-2,05). No quinto minuto, Apgar < 7 ocorreu em 0,7% em todos os tipos de partos. O SF foi a terceira causa de indicação de cesárea (22,8%), e o Apgar < 7 não diferenciou das cesáreas por demais causas. Conclusão: Este estudo demonstrou alta taxa de cesárea e maior risco de Apgar < 7 no primeiro minuto para esses partos. A ausência de diferença estatisticamente significante entre o Apgar dos RNs de cesárea por SF e demais indicações revela a necessidade local de rever esse diagnóstico e consequente conduta.(AU)


Objective: To evaluate the cesarean indications for fetal distress (FD), using the Apgar score, in a public hospital. Methods: Cross-sectional and retrospective study, which included all the deliveries performed during the period of study. Statistical Analysis was performed using the IBM SPSS Statistics v.22 software with Pearson's Chi-square test to calculate the p-value. The risk estimate for Apgar < 7 was defined by the common odds ratio (OR) of Mantel-Haenszel, with calculation of OR and 95% confidence interval and significance limit of 95% (p < 0.05). Results: Of the 2,205 deliveries, 1,084 (49.1%) were cesarean and 1,121 (50.9%) were vaginal deliveries. Apgar score < 7 in the 1st minute was seen in 5.9% of total deliveries. The difference between the Apgar Scores in the 1st minute between the two types of delivery was statistically significant (p < 0.05), and these newborns (NBs) had 1.4 times more chance of Apgar < 7 in cesarean in relation to vaginal delivery (OR: 1,4; IC95%: 1-2,05). In the 5th minute, Apgar < 7 occurred in 0.7% of all types of births. FD was the third cause of cesarean indication (22.8%) and the Apgar < 7 wasn't different from the cesareans performed for other causes. Conclusion: This study demonstrated a high cesarean rate and a bigger risk of Apgar < 7 in the 1st minute for this type of delivery. The absence of statistically significant difference between the Apgar of NBs of cesarean due to FD and other indications reveal the need to review this diagnosis e it's conduct.(AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Apgar Score , Cesarean Section/statistics & numerical data , Fetal Distress/epidemiology , Brazil/epidemiology , Labor, Obstetric , Cross-Sectional Studies , Parturition
9.
BioSC. (Curitiba, Impresso) ; 80(Supl.1): 9-13, 20220000.
Article in Portuguese | LILACS | ID: biblio-1417631

ABSTRACT

O escore de Apgar avalia rapidamente o estado clínico de neonatos. A asfixia perinatal é uma das causas do baixo índice de Apgar e contribui significativamente com a morbimortalidade. Objetivo: Avaliar a prevalência do Apgar baixo no quinto minuto de vida e determinar o perfil epidemiológico desses pacientes. Método: É estudo retrospectivo transversal epidemiológico. Foram coletados os dados dos recém-nascidos vivos com Apgar 5' <7 de 2 anos. Excluiu-se pacientes com anomalias congênitas e 118 pacientes foram analisados. Resultados: A prevalência do Apgar 5' <7 foi de 21,47/1000. Sexo masculino, nascimento a termo e por cesárea, apresentação cefálica, bolsa rota no ato, gestações simples, mães entre 20 e 34 anos com hipotireoidismo e diabetes, em uso de medicação, e mais de 6 consultas de pré-natal foram a maioria dentre os fatores analisados. Do total, 33,9% eram pré-termo; 30,5% tinham baixo peso; 24% apresentaram líquido amniótico meconial; 16% distócia; e 13% circular de cordão. Conclusão: A prevalência do Apgar 5' <7 foi de 21,47/1000. O perfil epidemiológico dentre os fatores analisados foi sexo masculino, nascimento a termo e por cesárea, apresentação cefálica, bolsa rota no ato, gestações simples, mães entre 20-34 anos com hipotireoidismo e diabete, em uso de medicação, e mais de 6 consultas de pré-natal


The Apgar score quickly assesses the clinical status of neonates. Perinatal asphyxia is one of the causes of low Apgar scores and contributes significantly to neonatal morbidity and mortality. Objective: To evaluate the prevalence of low Apgar in the fifth minute of life and to determine the epidemiological profile of these patients. Method: It is a retrospective cross-sectional epidemiological study. Data were collected from live newborns with Apgar5' <7 over 2 years. Patients with congenital anomalies were excluded, and 118 patients were analyzed. Results: The prevalence of Apgar 5' <7 was 21.47/1000. Male, full-term and cesarean delivery, cephalic presentation, water breaking during labor, singlet pregnancies, mothers between 20 and 34 years old with hypothyroidism and diabetes, using medication, and more than 6 prenatal consultations were the majority among the analyzed factors; 33.9% were preterm; 30.5% underweight; 24% had meconium-stained amniotic fluid; 16% dystocia and 13% nuchal cord. Conclusion: The prevalence of Apgar 5' <7 was 21.47/1000. The epidemiological profile among the analyzed factors was male gender, full-term birth and by cesarean section, cephalic presentation, ruptured water at the moment, simple pregnancies, mothers between 20-34 years old with hypothyroidism and diabetes, using medication, and more than 6 consultations of prenatal care


Subject(s)
Humans , Infant, Newborn , Apgar Score , Asphyxia Neonatorum , Health Profile , Infant, Newborn , Prenatal Care , Cesarean Section , Diabetes Mellitus , Hypothyroidism
10.
Rev. ecuat. pediatr ; 22(3): 1-9, 30 de diciembre del 2021.
Article in Spanish | LILACS | ID: biblio-1352454

ABSTRACT

Introducción: La evaluación de la transición desde el medio intrauterino en los recién naci-dos se realiza con el puntaje de Apgar (1953), proporciona una evaluación rápida del estado clínico, sin embargo, contiene variables subjetivas en su calificación. El nuevo puntaje de Reanimación y Adaptación Neonatal incorpora intervenciones de la reanimación neonatal. El objetivo fue demostrar la no inferioridad del nuevo puntaje frente al de Apgar. Métodos: Se realizó un estudio observacional, descriptivo de corte transversal que empleó simultáneamente las dos puntuaciones. Con una muestra de 396 neonatos. El análisis uni-varial usó frecuencias absolutas y relativas y el bivarial usó Curvas ROC para la exactitud diagnóstica y pruebas significancia estadística. Resultados: La necesidad de reanimación fue del 35,6%, de ventilación mecánica del 19,6% y el diagnóstico de asfixia del 22%. La Curva ROC que examinó la variable asfixia mostró un índice de Youden a favor del nuevo puntaje, en el primer y quinto minuto, con similares resultados en las variables ventilación mecánica y reanimación neonatal. Conclusión: el puntaje de Reanimación y Adaptación Neonatal no es inferior al de Apgar en la valoración de asfixia. Al igual que su predecesor reconoce la necesidad de reanimación así como la necesidad de ventilación mecánica en los neonatos con puntuaciones bajas. Es una nueva herramienta de fácil aplicación y comprensión para la determinación del estado de transición en los recién nacidos.


Introduction: Evaluation of the transition from the intrauterine environment in newborns is carried out with the Apgar score (1953), which provides a quick estimation of the clinical state; however, it contains subjec-tive variables in its qualification. The new Neonatal Resuscitation and Adaptation score incorporates neo-natal resuscitation interventions. The objective was to demonstrate the noninferiority of the new score compared to the Apgar score. Methods: An observational, descriptive, cross-sectional study was carried out that used the two scores sim-ultaneously. With a sample of 396 neonates. The univariate analysis used absolute and relative frequen-cies, and the bivarial analysis used ROC curves for diagnostic accuracy and statistical significance tests. Results: The need for resuscitation was 35.6%, mechanical ventilation was 19.6%, and the diagnosis of as-phyxia was 22%. The ROC curve that examined the variable asphyxia showed a Youden index in favor of the new score in the first and fifth minutes, with similar results in the variables mechanical ventilation and neo-natal resuscitation. Conclusion: The neonatal resuscitation and adaptation scores were not lower than the Apgar score in the assessment of asphyxia. Like its predecessor, it recognizes the need for resuscitation as well as the need for mechanical ventilation in neonates with low scores. It is a new tool with easy application and understand-ing for the determination of the transition state in newborns


Subject(s)
Humans , Infant, Newborn , Apgar Score , Asphyxia Neonatorum , Infant, Newborn , Cardiopulmonary Resuscitation , Adaptation to Disasters , Live Birth
11.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(4): 979-986, Oct.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1360723

ABSTRACT

Abstract Objectives: to describe the profile of women affected with premature childbirth and neonatal outcomes at a referral maternity in the city of Fortaleza-CE, Brazil. Methods: descriptive and retrospective documentary type study, with a quantitative approach, carried out from January to December, 2017, with 253 medical records of women who had premature childbirth in a referral maternity. Results: the average age was 28, with the prevalence of women living in a stable union, graduated from high school and without formal work. The gestational mean average was three pregnancies, gestational age of 34 weeks and three days, and six prenatal consultations, starting in the first trimester. The major intercurrence was pre-eclampsia. In relation to the neonatal data, there was a prevalence of male newborns, with an average of 2.251 kg and a score of seven on the 1-minute Apgar and eight on the 5-minute Apgar. Newborns in going to a hospital accommodation after childbirth and in room air, spending an average of 12.71 days in the hospital. Conclusion: in this case of this research, knowing the woman's profile and the outcomes in premature newborns is useful to encourage public policies and reduce the sequelae on mother and baby


Resumo Objetivos: descrever o perfil de mulheres acometidas por parto prematuro e os desfechos neonatais em maternidade de referência, na cidade de Fortaleza-CE, Brasil. Métodos: estudo do tipo documental, descritivo, retrospectivo, com abordagem quantitativa, realizadode janeiro a dezembro de 2017, com 253 prontuários de mulheres que tiveram parto prematuro em maternidade de referência. Resultados: média de idade de 28 anos, com prevalência de mulheres vivendo em união estável, ensino médio completo, sem trabalho formal. A média gestacional foi de três gravidezes, idade gestacional de 34 semanas e trêsdias e seis consultas de pré-natal, iniciando no primeiro trimestre. A maior intercorrência foi a pré-eclâmpsia. Relacionado aos dados neonatais, houve prevalência de recém-nascidos do sexo masculino, com média de 2,251 quilos e escore sete no Apgar do 1º minuto e oito, no Apgar do 5º minuto. Recémnascidos indo para alojamento conjunto após o parto e em ar ambiente, tendo passado, em média, 12,71 dias internados. Conclusões: no caso da pesquisa, conhecer o perfil dessa mulher e os desfechos do recém-nascido prematuro é útil para estimular as políticas públicas e diminuir as sequelas para mãe e bebê.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications/epidemiology , Risk Factors , Obstetric Labor Complications/epidemiology , Obstetric Labor, Premature/epidemiology , Apgar Score , Prenatal Care , Brazil/epidemiology , Medical Records , Postpartum Period
12.
Rev. inf. cient ; 100(4): e3438, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289655

ABSTRACT

RESUMEN Introducción: La depresión cardiorrespiratoria neonatal es un problema clínico que, en dependencia de su etiología, conduce a una alta morbilidad neurológica y elevada mortalidad. Objetivo: Caracterizar al recién nacido con depresión cardiorrespiratoria en el servicio de Neonatología del Hospital Ginecobstétrico "Fé del Valle Ramos", de Manzanillo, Granma. Método: Se realizó un estudio retrospectivo, observacional, descriptivo y transversal. Se seleccionaron 88 neonatos que cumplieron con los criterios de inclusión de recién nacido con depresión cardiorrespiratoria. Los datos se recolectaron durante el período de enero de 2017 a diciembre de 2018. Se tomaron en cuenta las siguientes variables: puntaje de Apgar, años de estudio, sexo, tipo de depresión cardiorrespiratoria, peso al nacer, factores maternos, edad gestacional y afecciones asociadas. Resultados: La depresión severa al nacer predominó en la mayoría de los neonatos (56,8 %). Prevalecieron los recién nacido de buen peso (73,9 %), nacidos a término (77,2 %). Las infecciones maternas (45,5 %) durante la gestación, el tiempo de rotura de membranas prolongado (31,8 %) y la presencia de líquido amniótico meconial (30,7 %), constituyeron los factores maternos que mayor vínculo guardaron con el neonato deprimido. Conclusiones: Las infecciones maternas, la rotura prematura de membranas, la presencia de líquido amniótico meconial, los nacimientos por cesárea, la nuliparidad, prematuridad y el embarazo en la adolescencia, son algunos de los factores de riesgo relacionados en este estudio que guardan vínculo estrecho con el predominio de estas afecciones en los neonatos deprimidos.


ABSTRACT Introduction: The cardiorespiratory depression in neonates is a clinical complication that, depending on its etiology, leads to high neurological morbidity and mortality. Objective: To characterize neonates with cardiorespiratory depression treated in the neonatology service at the Hospital Ginecobstétrico "Fé del Valle Ramos" in Manzanillo, Granma. Method: A retrospective, observational, descriptive and cross-sectional study was carried out. A total of 88 neonates with cardiorespiratory depression criteria were selected in the study. All information gathered includes the period January 2017 throughout December 2018. Variables assessed were as follow: Apgar score, years of study, sex, type of cardiorespiratory depression, birth weight, maternal factors, gestational age and associated conditions. Results: Severe depression at birth was predominant in most of neonates (56.8%). Newborn infants with a normal birth weight (73.9%), and born at term (77.2%) were predominant. Maternal infections during gestation (45.5%), prolonged rupture of membranes (31.8%) and the presence of meconium in the amniotic fluid (30.7%) were the maternal factors most associated with depressed neonate. Conclusions: The maternal infections, premature rupture of membranes, the presence of meconium in the amniotic fluid, cesarean birth, nulliparous status, premature and adolescent pregnancy are some of the risk factors assessed in this study that are closely linked to the prevalence of arising conditions in depressed neonates.


RESUMO Introdução: A depressão cardiorrespiratória neonatal é um problema clínico que, dependendo de sua etiologia, leva a alta morbidade neurológica e alta mortalidade. Objetivo: Caracterizar o recém-nascido com depressão cardiorrespiratória no serviço de Neonatologia do Hospital Gineco-obstétrico "Fé del Valle Ramos", Manzanillo, Granma. Método: Foi realizado um estudo retrospectivo, observacional, descritivo e transversal. Foram selecionados oitenta e oito lactentes que atenderam aos critérios de inclusão de um recém-nascido com depressão cardiorrespiratória. Os dados foram coletados no período de janeiro de 2017 a dezembro de 2018. Foram consideradas as seguintes variáveis: índice de Apgar, anos de estudo, sexo, tipo de depressão cardiorrespiratória, peso ao nascer, fatores maternos, idade gestacional e condições associadas. Resultados: A depressão grave ao nascer prevaleceu na maioria dos neonatos (56,8%). Prevaleceram os recém-nascidos de bom peso (73,9%) e a termo (77,2%). Infecções maternas (45,5%) durante a gestação, tempo prolongado de ruptura da membrana (31,8%) e presença de líquido amniótico mecônio (30,7%) foram os fatores maternos mais associados ao neonato deprimido. Conclusões: Infecções maternas, ruptura prematura de membranas, presença de líquido amniótico mecônio, partos cesáreos, nuliparidade, prematuridade e gravidez na adolescência, são alguns dos fatores de risco relacionados neste estudo que estão intimamente ligados ao predomínio dessas condições na recém-nascidos deprimidos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Apgar Score , Respiratory Insufficiency/epidemiology , Infant, Newborn, Diseases/mortality , Infant, Newborn, Diseases/epidemiology , Pregnancy Complications/etiology , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Observational Studies as Topic
13.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(3): 805-815, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1347002

ABSTRACT

Abstract Objectives: to analyze factors associated with neonatal death among adolescent mothers. Methods: randomized hospital-based cross-sectional study in a tertiary institution,, data from the Sistema de Informação sobre Nascidos Vivos (Sinasc), (Live Birth Information System), Sistema de Informação sobre Mortalidade (SIM) (Mortality Information System), and medical records. The study population was comprised of 1,341 adolescents aged 10-19 who had assisted childbirth at the institution between 2012 to 2016. The independent variables were sociodemographic characteristics, care, prenatal, childbirth, birth, and newborn's hospitalization, as well as the baby's characteristics. Logistic regression analysis was carried out to assess the association between neonatal death and explanatory variables. Results: the factors associated with death were from the countryside or other States (OR=2.68; CI95% =1.24-5.81), Apgar scores lower than 7 in the 1st (OR= 9.52; CI95% = 4.15-21.81) and the 5th (OR=4.17; CI95%=1.53-11.34) minutes of life; and birth weight less than 999g (OR=13.37; CI95% =3, 64-49.04) and between 1,500 to 2,499g (OR=3.43; CI95%=1.37-8.58). Conclusions: apgar and low birth weight were associated with the neonatal death among adolescent mothers, as well as the fact they come from the countryside and other States. These findings show, in addition to classic risks, potential difficulties for adolescents in having access to healthcare services in their hometown. To reduce the risks, there is a need for restructuring the maternal and child healthcare network and ensure a social protection network for these girls.


Resumo Objetivos: analisar fatores associados ao óbito neonatal de mães adolescentes. Métodos: estudo transversal de base hospitalar em instituição terciária, randomizado, com dados do Sistema de Informação sobre Nascidos Vivos (Sinasc), Sistema de Informação sobre Mortalidade (SIM) e de prontuários. A população do estudo compreendeu 1.341 adolescentes de 10 a 19 anos assistidos durante o parto na instituição entre 2012 a 2016. As variáveis independentes foram características sociodemográficas, assistenciais, relacionadas ao pré-natal, parto, nascimento e internamento do recém-nascido, além das características do bebê. Realizou-se análise de regressão logística para avaliar a associação entre óbito neonatal e variáveis explanatórias. Resultados: os fatores associados ao óbito foram municípios do interior e outros estados (OR=2,68; IC95%=1,24-5,81), índices de apgar menor que sete no 1º(OR=9,52; IC95%=4,15-21,81) e no 5º(OR=4,17; IC95%=1,53-11,34) minutos de vida e peso ao nascer menor que 999g (OR=13,37; IC95%= 3,64-49,04) e entre 1500 a 2499g (OR=3,43; IC95%= 1,37-8,58). Conclusões: o apgar e o baixo peso ao nascer se associaram ao óbito neonatal de mães adolescentes além da procedência de municípios do interior e outros estados. Estes achados mostram além de riscos clássicos, potenciais dificuldade das adolescentes em dispor de assistência nos seus lugares de residência. Para reduzir os riscos há necessidade de reorganizar a rede assistencial materno-infantil e garantir uma rede de proteção social a estas meninas.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Adolescent , Adult , Pregnancy in Adolescence , Risk Factors , Cause of Death , Perinatal Death/etiology , Apgar Score , Prenatal Care , Socioeconomic Factors , Tertiary Healthcare , Brazil , Infant, Low Birth Weight , Cross-Sectional Studies , Maternal-Child Health Services
14.
Article in Portuguese | LILACS, CONASS, SES-GO, ColecionaSUS | ID: biblio-1354753

ABSTRACT

Objetivo: caracterizar partos e nascidos vivos a partir de dados retirados do Sistema de Informação sobre Nascidos Vivos. Método: estudo descritivo, de abordagem quantitativa, com dados de nascimentos no ano de 2016, no município de Palmeiras de Goiás, Goiás, Brasil. Os dados foram obtidos pelo Departamento de Informática do Sistema Único de Saúde (DATASUS). Resultados: foram incluídos 391 nascimentos ocorridos no ano de 2016. Maiores frequências ocorreram entre mães com idade entre 20 a 24 anos (27,1%), seguidas das mães de 25 a 29 anos (24,3%) e das mais jovens com idade entre 15 a 19 anos (21,0%), prevalecendo a duração da gestação de 37 a 41 semanas (86,4%), com gravidez única (97,4%), em parto tipo cesáreo (81,3%), recém-nascidos do sexo feminino (50,4%), com raça/cor parda (62,1%), peso ao nascer entre 3000g a 3999g (67,5%), sem presença de anomalia no nascimento (93,6%), e com Apgar 1º minuto e 5º entre 8 e 10, com 88,2% e 98,2%, respectivamente. Conclusão: os dados deste estudo podem subsidiar políticas públicas no município para garantir atenção integral e de qualidade no ciclo gravídico-puerperal e que repercutam na melhoria dos indicadores de saúde materno-infantil


Objective: to characterize births and live births from data collected from the Live Birth Information System. Method: descriptive study with a quantitative approach, with data on births in 2016, in the city of Palmeiras de Goiás, Goiás, Brazil. Data were obtained by the Informatics Department of the Unified Health System (DATASUS). Results: 391 births occurred in 2016 were included. Higher frequencies occurred among mothers aged 20 to 24 years (27.1%), followed by mothers aged 25 to 29 years (24.3%) and the youngest with aged between 15 and 19 years (21.0%), with a prevalence of gestation of 37 to 41 weeks (86.4%), with a single pregnancy (97.4%), in a cesarean delivery (81.3%) , female newborns (50.4%), with mixed race/color (62.1%), birth weight between 3000g and 3999g (67.5%), no abnormality at birth (93.6 %), and with Apgar 1st and 5th minutes between 8 and 10, with 88.2% and 98.2%, respectively. Conclusion: the data from this study can support public policies in the city to ensure comprehensive and quality care in the pregnancy-puerperal cycle and that have an impact on the improvement of maternal and child health indicators


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Adolescent , Adult , Middle Aged , Parturition , Live Birth , Apgar Score , Prenatal Care , Brazil , Information Systems/statistics & numerical data
15.
Chinese Journal of Contemporary Pediatrics ; (12): 588-592, 2021.
Article in Chinese | WPRIM | ID: wpr-879898

ABSTRACT

OBJECTIVE@#To investigate the factors contributing to the withdrawal from treatment in neonates with respiratory failure.@*METHODS@#The medical data of 2 525 neonates with respiratory failure were retrospectively studied, who were reported in 30 hospitals of Jiangsu Province from January to December, 2019. According to whether a complete treatment was given, they were divided into a complete treatment group with 2 162 neonates and a withdrawal group with 363 neonates. A multivariate logistic regression analysis was used to investigate the factors contributing to the withdrawal from treatment in neonates with respiratory failure.@*RESULTS@#The multivariate logistic regression analysis showed that small-for-gestational-age birth, congenital abnormality, gestational age < 28 weeks, living in the rural area or county-level city, and maternal age < 25 years were risk factors for the withdrawal from treatment in neonates with respiratory failure (@*CONCLUSIONS@#Small-for-gestational-age birth, congenital abnormality, gestational age, living area, maternal age, Apgar score at birth, and method of birth are contributing factors for the withdrawal from treatment in neonates with respiratory failure. A poor prognosis and a low quality of life in future might be major immediate causes of withdrawal from treatment in neonates with respiratory failure, which needs to be confirmed by further studies.


Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Apgar Score , Cesarean Section , Gestational Age , Quality of Life , Respiratory Insufficiency/therapy , Retrospective Studies , Risk Factors
16.
Chinese Journal of Contemporary Pediatrics ; (12): 283-287, 2021.
Article in Chinese | WPRIM | ID: wpr-879847

ABSTRACT

A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.


Subject(s)
Child , Child, Preschool , Female , Humans , Infant, Newborn , Pregnancy , Apgar Score , China , Resuscitation , Risk Factors
17.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 39: e2019317, 2021. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136772

ABSTRACT

ABSTRACT Objective: To compare 2012 and 2016 data on early neonatal near miss indicators from Health Information Systems at a university hospital. Methods: This is a cross-sectional study conducted in 2012 and 2016. We considered early neonatal near misses the live births that presented one of the following risk conditions at birth: gestational age <33 weeks, birth weight <1,750g or 5-minute Apgar score <7, or Neonatal Intensive Care Unit (NICU) admission, and were alive until the 7th day of life. Data were collected from the Live Birth Information System, Hospital Information System, and Mortality Information System. We calculated the early neonatal mortality rate, neonatal near miss rate, severe neonatal outcome rate, early neonatal survival index, and early neonatal mortality index, compared by year of birth. Results: In 2012, 304 early neonatal near misses were registered, with a higher proportion of cases with very low birth weight and mothers who had zero to three prenatal visits. In 2016, the number of cases was 243, with a predominance of more NICU admissions. The incidence of early neonatal deaths and early neonatal near misses was higher in 2012 than in 2016. Conclusions: Neonatal near miss indicators identified difference between years. The cases were more severe in 2012 and there were more NICU admissions in 2016.


RESUMO Objetivo: Comparar os anos de 2012 e 2016 quanto a indicadores de near miss neonatal precoce, com base nos dados de Sistemas de Informação em Saúde, em hospital universitário. Métodos: Estudo transversal realizado em 2012 e 2016. Consideraram-se casos de near miss neonatal precoce os nascidos vivos que apresentaram uma das condições de risco ao nascer (idade gestacional <33 semanas, peso ao nascer <1750 g, índice de Apgar no 5º minuto de vida <7, ou internação em unidade de terapia intensiva neonatal - UTIN) e que permaneceram vivos até o 7º dia de vida. Os dados foram obtidos do Sistema de Informações de Nascidos Vivos, do Sistema de Informações Hospitalares e do Sistema de Informação sobre Mortalidade. Calcularam-se a taxa de mortalidade neonatal precoce, a taxa de near miss neonatal, a taxa de desfecho neonatal grave, o índice de sobrevivência neonatal precoce e o índice de mortalidade neonatal precoce, comparados segundo o ano de nascimento. Resultados: Em 2012, ocorreram 304 casos de near miss neonatal precoce e maior proporção de casos com muito baixo peso ao nascer e de mães que realizaram nenhuma a três consultas de pré-natal. Em 2016 aconteceram 243 casos, com predomínio das internações em UTIN. O ano de 2012 teve mais óbitos neonatais precoces e mais casos de near miss neonatal precoce do que o de 2016. Conclusões: Os indicadores de near miss neonatal precoce identificaram diferenças entre os anos comparados, com maior gravidade em 2012 e, em contrapartida, maior número de internações em UTIN em 2016.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child , Adolescent , Adult , Young Adult , Intensive Care Units, Neonatal/statistics & numerical data , Infant Mortality , Near Miss, Healthcare/statistics & numerical data , Apgar Score , Prenatal Care/statistics & numerical data , Brazil/epidemiology , Infant, Premature , Cross-Sectional Studies , Infant, Very Low Birth Weight , Hospitals, University/statistics & numerical data
18.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200102, 2021. tab
Article in Portuguese | BDENF, LILACS | ID: biblio-1124794

ABSTRACT

RESUMO Objetivo identificar os fatores associados às práticas assistenciais ao recém-nascido adotadas na sala de parto de uma maternidade na baixada litorânea do Rio de Janeiro. Método estudo transversal, realizado em instituição pública no estado Rio de Janeiro, mediante coleta de dados em prontuários de nascimentos entre 2015 e 2017. Na associação entre variáveis, adotou-se o Teste Qui-Quadrado e a regressão logística. Resultados entre 351 (100,0%) prontuários, constituíram-se como práticas realizadas na sala de parto: contato pele a pele e aleitamento materno precoce (28,0%); secagem (92,3%); aspiração oronasofaríngea (82,1%); aspiração gástrica (52,7%); aspiração traqueal (12,2%); oxigênio inalatório (7,7%); e encaminhamento ao Alojamento Conjunto (91,1%). O contato precoce com o seio materno esteve associado ao tipo de parto (p=0,043) e às alterações no exame físico (p=0,001). Possuir alterações no exame físico ao nascimento diminuiu significativamente as chances de o bebê ser colocado nessa posição ainda na sala de parto (p=0,001) assim como os recém-nascidos de parto cesáreo (p=0,045). Nascer de cesárea aumentou duas vezes as chances de o recém-nascido ser submetido à aspiração gástrica (p=0,002). Conclusão e implicações para a prática é premente organizar as rotinas dos serviços, de modo a evitar intervenções desnecessárias visando uma atenção obstétrica e neonatal humanizada e de qualidade.


ABSTRACT Objective to identify the factors associated with newborn care practices adopted in the delivery room of a maternity hospital in the coastal lowlands of Rio de Janeiro. Method a cross-sectional was study carried out in a public institution in the state of Rio de Janeiro using data collected from birth records between 2015 and 2017. The chi-square test and logistic regression were adopted to associate the variables. Results among 351 (100.0%) medical records, the following constituted practices performed in the delivery room: skin-to-skin contact and early breastfeeding (28.0%); drying (92.3%); oronasopharyngeal aspiration (82.1%); gastric aspiration (52.7%); tracheal aspiration (12.2%); inhaled oxygen (7.7%); and rooming-in referral (91.1%). Early breastfeeding was associated with the type of delivery (p=0.043) and changes in physical examination (p=0.001). Changes in the physical examination at birth significantly decreased the chances of babies being placed in this position while still in the delivery room (p=0.001), as well as newborns delivered by cesarean section (p=0.045). Being born by cesarean section increased the chances of newborns being submitted to gastric aspiration twice (p=0.002). Conclusion and implications for practice it is urgent to organize the routines of services in order to avoid unnecessary interventions aiming at humanized and quality obstetric and neonatal care.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Adult , Young Adult , Perinatal Care/statistics & numerical data , Delivery Rooms/standards , Evidence-Based Practice , Apgar Score , Prenatal Care/statistics & numerical data , Rooming-in Care , Breast Feeding , Cesarean Section/statistics & numerical data , Cross-Sectional Studies , Humanization of Assistance , Natural Childbirth/statistics & numerical data
19.
Femina ; 49(9): 556-571, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1342326

ABSTRACT

Objetivo: Determinar a correlação entre vias de parto, locais de parto e prognóstico neonatal por meio do índice de Apgar e a capacidade de diagnosticar malforma- ções. Métodos: A pesquisa foi realizada no Sistema de Informação de Nascidos Vivos para variáveis de parto e malformações. Também correlacionamos o Apgar com ou sem malformação fetal e local do parto. Resultados: Houve uma quantidade considerável de dados de Apgar indefinidos, especialmente em partos domiciliares. Os partos domiciliares com malformações fetais com Apgar 0-2 e 3-5 no primeiro minuto também apresentaram piores taxas de recuperação no quinto minuto em comparação a cesárea e parto vaginal intra-hospitalar. O registro do diagnóstico das malformações fetais ocorre em ambiente hospitalar e é mais frequente do que no domiciliar. Recém-nascidos com malformações fetais apresentaram maiores taxas de Apgar ao nascer em ambiente hospitalar. As anomalias associadas aos piores prognósticos foram neurológicas e cardiológicas, enquanto as menos associadas foram as de pés e quadris. Conclusão: Esta pesquisa sugere que a cesárea e o parto hospitalar estão correlacionados a um melhor prognóstico do recém-nascido com malformação, bem como a capacidade de diagnosticar doenças congênitas que potencialmente requerem intervenção médica imediata.(AU)


Objective: To determine the correlation between delivery routes, delivery sites and neonatal prognosis through Apgar score and the ability to diagnose malformations. Methods: Research was carried out in the Live Birth Information System for delivery variables and malformations. We also correlated Apgar with or without fetal malformation and delivery site. Results: There was a considerable amount of undefined Apgar data, especially in home births. Home births with fetal malformations with Apgar 0-2 and 3-5 in the first minute also showed worse recovery rates in the fifth minute compared to cesarean section and intra-hospital vaginal delivery. Registration of the diagnosis of fetal malformations occurs in a hospital environment and is more frequent than at home. Newborns with fetal malformations had higher Apgar rates when born in a hospital environment. The abnormalities associated with the worst prognoses were neurological and cardiological, while the least associated were those of the feet and hips. Conclusion: This research suggests that caesarean section and hospital births are correlated with a better prognosis of the newborn with malformation, as well as ability to diagnose congenital diseases that potentially require immediate medical intervention.(AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Apgar Score , Congenital Abnormalities/diagnosis , Congenital Abnormalities/epidemiology , Parturition , Prognosis , Cesarean Section , Birth Setting , Home Childbirth , Natural Childbirth
20.
Arch. argent. pediatr ; 118(6): 405-415, dic 2020. tab, ilus
Article in English, Spanish | BINACIS, LILACS | ID: biblio-1146069

ABSTRACT

Objetivo. Investigar la frecuencia de la enterocolitis necrosante (ECN) en prematuros y evaluar los factores de riesgo asociados con su aparición y progresión a perforación intestinal.Métodos. Cohorte retrospectiva de prematuros hospitalizados entre 2015 y 2018. Las características perinatales, clínicas, nutricionales y de laboratorio se analizaron con SPSS-23, y los factores de riesgo mediante una regresión logística.Resultados. En 1428 neonatos, la tasa de ECN fue del 18,28 %. La concepción por reproducción asistida, la cesárea y los corticoesteroides posnatales se asociaron con ECN (OR: 4,056; IC del 95 %: 2,810-5,854; OR: 1,961; IC del 95 %: 1,321-2,910; OR: 6,422; IC del 95 %: 4,327-9,530). El momento de la primera alimentación enteral se asoció con ECN, pero no con perforación intestinal (p < 0,001; p = 0,604). De 261 pacientes con ECN, 47 (18 %) tuvieron perforación intestinal. El momento de la primera alimentación enteral y el ductus persistente con repercusión hemodinámica fueron factores predisponentes para ECN, y el puntaje de Apgar bajo al minuto 5 para perforación intestinal. (OR: 6,515; IC del 95 %: 5,011-8,470; OR: 4,715; IC del 95 %: 2,717-8,183; OR: 2,748; IC del 95 %: 1,100-6,866). La mortalidad fue del 9 %. La ECN aumentó el riesgo de mortalidad 2,192 veces (IC del 95 %: 1,469-3,271); en perforación intestinal, el riesgo aumentó 11,527 veces (IC del 95 %: 6,293-21,115).Conclusión. El conducto arterial persistente y el retraso en la primera nutrición enteral fueron factores predisponentes para ECN, y el puntaje de Apgar bajo al minuto 5 para perforación intestinal.


Aim. To investigate NEC frequency in premature infants and assess risk factors associated with disease-onset and progression to intestinal perforation.Methods. Retrospective cohort in preterm neonates hospitalized between 2015 and 2018. Perinatal characteristics, clinical features, nutritional data and laboratory outcome were analyzed using SPSS-23 statistical package. Logistic regression was performed to analyze associated risk factors.Results. In 1428 neonates, the rate of developing NEC was 18.28 %. Conception with assisted reproductive technology, cesearean section and postnatal-steroids were associated with NEC (OR: 4.056, 95 % CI: 2.810-5.854, OR: 1.961, 95 % CI: 1.321-2.910, OR: 6.422; 95 % CI: 4.327-9.530).Timing of first enteral feeding was associated to developing NEC, but not to intestinal perforation (p < 0.001, p = 0.604). Forty-seven of 261 NEC patients (18 %) have developed intestinal perforation. Antenatal steroids showed to reduce severe consequences (p = 0.001). Timing of first enteral feeding and hemodynamically significant PDA were predisposing factors for NEC and low 5-minutes Apgar score for intestinal perforation. (OR: 6.515; 95 % CI: 5.011-8.470; OR: 4.715; 95 % CI: 2.717-8.183; OR: 2.748; 95 % CI: 1.100-6.866).Mortality was 9 %. Developing NEC increased risk of mortality by 2.192 times (95 % CI: 1.469-3.271); in intestinal perforation, mortality risk increased to 11.527 (95 % CI: 6.293-21.115).Conclusion. NEC frequency was 18.28 %. Intestinal perforation occurred in 18 % of NEC patients. PDA and delay in first enteral nutrition were predisposing factors for acquiring NEC and low 5-minutes Apgar scores for intestinal perforation


Subject(s)
Humans , Male , Female , Infant, Newborn , Enterocolitis, Necrotizing , Intestinal Perforation/diagnostic imaging , Apgar Score , Turkey , Infant, Premature , Intensive Care, Neonatal , Retrospective Studies , Risk Factors , Gestational Age , Enteral Nutrition
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