Factors associated with the quality of life of mothers of preterm infants with very low birth weight: a 3-year follow-up study.

AIM: To analyze possible factors associated with the quality of life (QoL) of mothers of preterm infants with very low birth weight (VLBW) during the first 3 years after delivery. METHODS: The World Health Organization Quality of Life (WHOQOL)-bref scores were compared and correlated with maternal and infant-related sociodemographic and clinical variables at maternal discharge (T0) and at 6 (T1), 12 (T2), 24 (T3), and 36 (T4) months after delivery. Multiple linear regression models were fitted to investigate the effect of these variables on the mothers' QoL. RESULTS: The WHOQOL-BREF physical domain scores were higher at T1 and T2 compared to T0 (p = 0.013). Maternal variables that contributed to maternal QoL scores (p < 0.05) were stable marital union (b = 13.60; T0), family income (b = -12.75; T3), Evangelical religion (b = 8.11; T4), and beck depression inventory (BDI) score (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3, and T4). Infants' variables that most affected maternal QoL (p < 0.05) were posthemorrhagic hydrocephalus (PHH) (-18.84 ≤ b ≤ -10.05; T1, T2, and T4), bronchopulmonary dysplasia (BPD) (b = -7.41; T2), female gender (b = 8.09; T2), and SNAPPE severity score (b = -0.23; T3). CONCLUSION: Mothers of preterm infants with VLBW exhibited transient improvements in physical well-being during the first year after delivery. The presence of depressive symptoms in mothers and the diagnosis of PHH or BPD were negatively associated with QoL. Social, religious, and economic aspects were also important factors for the QoL of mothers of preterm infants with VLBW.

Effect of neonatal intensive care unit environment on the incidence of hospital-acquired infection in neonates.

The influence of the inanimate hospital environment and hospital design on nosocomial infection is a topic for discussion. This study evaluated the impact of the neonatal intensive care unit (NICU) environment on the risk of hospital-acquired infection (HAI). HAI surveillance was performed during a four-year period when the NICU was moved initially from an old facility to temporary accommodation and then eventually to a new and better-designed facility. The rate of HAI rose significantly from 12.8 to 18.6% (P<0.01) after moving to the temporary unit, which had a lower sink:cot ratio and a higher monthly admission rate. In contrast, the rates of catheter-associated staphylococcal bacteraemia decreased significantly after moving to the new NICU (P<0.0001). Since peripherally inserted central catheters (PICCs) were introduced concomitantly with the move to the new unit, however, the catheter type may have contributed towards this reduction in CVC-related staphylococcal bacteraemias. Moving to a temporary NICU with poor handwashing facilities and higher admission activity resulted in higher rates of HAI.

An outbreak of conjunctivitis caused by multiresistant Pseudomonas aeruginosa in a Brazilian newborn intensive care unit.

We report an outbreak of conjunctivitis due to Pseudomonas aeruginosa involving seven infants admitted in the Neonatal Intensive Care Unit (NICU) of the Uberlândial Federal University Hospital between March and September 2001. Three infants developed systemic complications (01 sepsis and 02 pneumonias). Ten isolates were obtained from conjunctival cultures and all were resistant to ceftazidime and aminoglycosides. Fast identification of the organism and treatment with imipenem were important in containing the outbreak of P. aeruginosa.

An outbreak of conjunctivitis caused by multiresistant Pseudomonas aeruginosa in a Brazilian Newborn Intensive Care Unit

We report an outbreak of conjunctivitis due to Pseudomonas aeruginosa involving seven infants admitted in the Neonatal Intensive Care Unit (NICU) of the Uberlândial Federal University Hospital between March and September 2001. Three infants developed systemic complications (01 sepsis and 02 pneumonias). Ten isolates were obtained from conjunctival cultures and all were resistant to ceftazidime and aminoglycosides. Fast identification of the organism and treatment with imipenem were important in containing the outbreak of P. aeruginosa

Surfactant replacement therapy: a multicentric trial comparing two dosage approaches.

In this study the results of two different initial doses (Group A: 200 mg/kg--82 patients; Group B: 100 mg/kg--83 patients) of a porcine surfactant were compared in the treatment of neonatal respiratory distress syndrome. Main entry criteria were: birth weight between 700 and 2,000 grams, need of mechanical ventilation, FiO2 > or = 0.60 to obtain a PaO2 between 50 and 80 mmHg (PaO2/FiO2 < or = 133.3 mmHg) and less than 15 hours of postnatal age. Two further 100 mg/kg doses could be given in both groups at 12 hours interval if FiO2 was > 0.40. Birth weight (Group A: 1,231 +/- 281 g. and Group B: 1,324 +/- 355 g.), gestational age (Group A: 29.9 +/- 2.7 wk. and Group B: 30.6 +/- 2.6 wk.) and Apgar scores were similar in the two groups. Group A had a significantly higher mean PaO2/FiO2 ratio (p < 0.05) after 12 hours--178 (40-506) vs 133 (17-243) mmHg, before receiving a 2nd dose, after 24 hours--180 (17-431) vs 152 (39-360), and in the 3rd day--177 (40-333) vs 124 (24-249) and needed a lower FiO2 (p < 0.05) after 36 hours (0.47 +/- 0.20 vs 0.53 +/- 0.23) and on the 3rd day (0.51 +/- 0.23 vs 0.61 +/- 0.24). The mean peak inspiratory pressure was lower in Group A at 36 hours (17.5 +/- 4.5 vs 20.6 +/- 6.8) after the initial dose (p < 0.05). The time of exposure to high oxygen concentrations (FiO2 > or = 0.40) was lower in Group A--85 (3-643) vs 131 (3-672) hours; p < 0.05). Total amount of phospholipids given per patient was meanly 224 mg in Group A and 144 mg in Group B. Mortality was lower in group A but without significant difference (Group A: 17/82; Group B: 26/83). The analysis of the subgroup of babies with less than 1,500 gr. at birth showed a statistically significant difference in mortality (Group A: 15/70; Group B: 24/56; p < 0.02).

[Growth of preterm infants]. / Crescimento de recém-nascidos pré-termo.

A hundred-forty-one infants born from 26 to 36 weeks, appropriate-for-gestational-age, were followed from birth until the corrected postmenstrual age of 42 weeks. Weight, height and cephalic perimeter were measured on a weekly basis. Based on the average values and percentiles of these measurements it was adjusted a third degree polynomial function. The growth curves obtained, when compared with the so-called intra-uterine growth curves, showed that during the 40th and 42nd postmenstrual weeks the averages and medians are similar. It was observed that the growth dynamics of the preterm infants showed a catch-up pattern in the immediate postnatal period.