Ruptura prematura das membranas amnióticas no pré-termo: fatores associados à displasia broncopulmonar / Preterm premature rupture of the fetal membranes: factors associated with bronchopulmonary dysplasia
Rev. bras. ginecol. obstet
; 32(10): 497-503, out. 2010. tab
Article
in Portuguese
| LILACS
| ID: lil-572631
Responsible library:
BR1.1
RESUMO
OBJETIVO:
identificar os fatores obstétricos e neonatais associados ao desfecho de displasia broncopulmonar em pacientes com amniorrexe prematura no pré-termo.MÉTODOS:
foram analisados 213 prontuários do Instituto Fernandes Figueira, entre 1998 e 2002, cujas pacientes evoluíram com quadro de amniorrexe prematura <34 semanas de gestação. Foram excluídas gestações múltiplas. As variáveis de natureza clínico-obstétricas e neonatais foram cotejadas com o desfecho de displasia broncopulmonar. Os dados foram submetidos à análise bivariada, sendo os valores que exibiam significância estatística (p<0,05) submetidos à regressão logística.RESULTADOS:
a prevalência de displasia broncopulmonar foi de 6.10 por cento. A análise univariada dos fatores associados ao desfecho de displasia broncopulmonar exibiu os seguintesresultados:
tempo de ventilação mecânica neonatal >10 dias (OR 54,00 [11,55-278,25] p=0,000); idade gestacional <30 semanas (OR 6,33 [1,26-43,06] p=0,017) peso <1.000 g (OR 4,82 [1,34-17,53] p=0,010); peso <1.500 g (OR 14,09 [1,82-300,50] p=0,003; persistência do canal arterial (OR 12,33 [3,07-50,10], p=0,000); doença da membrana hialina (OR 8,46 [2,21-35,00] p=0,000); pneumonia congênita (OR 7,48 [2,03-27,93] p=0,000); uso de surfactante neonatal (OR 19,66 [4,54-97,76] p=0,000) e infecção neonatal (OR 7,67 [0,99-163,79] p=0,049). No modelo multivariado final, somente as variáveis "ventilação mecânica">10 dias (p=0,001) e "uso de surfactante" (p=0,040) permaneceram independentemente associadas ao desfecho.CONCLUSÕES:
observou-se que os fatores associados à displasia broncopulmonar são de natureza neonatal, sendo que a ventilação mecânica duradoura e o uso de surfactante neonatal influenciaram no desenvolvimento dessa doença.ABSTRACT
PURPOSE:
to analyze obstetric and neonatal factors associated with bronchopulmonary dysplasia outcome in patients with preterm premature amniorrhexis.METHODS:
we analyzed 213 medical records of patients of Fernandes Figueira Institute who suffered premature amniorrhexis (<34 weeks of gestation) in the period from 1998 to 2002. Multiple gestations were excluded. Clinical-obstetric and neonatal variables were considered in relation to the bronchopulmonary dysplasia outcome. Data were subjected to bivariate analysis, and the values showing statistical significance (p<0.05) were subjected to logistic regression analysis.RESULTS:
the prevalence of bronchopulmonary dysplasia was 6.10 percent. Univariate analysis of the factors associated with the pulmonary dysplasia outcome were neonatal mechanical ventilation for more than ten days(OR 54.00 [11.55-278.25] p=0.000); birth gestational age of less than 30 weeks (OR 6.33 [1.26- 43.06] p=0.017); birth weight <1,000 g (OR 4.82 [1.34-17.53] p=0.010); birth weight <1.500 g (OR 14.09 [1.82-300.50] p=0.003; patent ductus arteriosus (OR 12.33 [3.07-50.10], p=0.000); hyaline membrane disease (OR 8.46 [2.21-35.00] p=0.000); congenital pneumonia (OR 7.48 [2.03-27.93] p=0.000); use of neonatal surfactant (OR 19.66 [4.54-97.76] p=0.000), and neonatal infection (OR 7.67 [0.99-163.79] p=0.049). In the final multivariate model, only the variables "neonatal mechanical ventilation">10 days (p=0.001) and "use of a surfactant" (p=0.040) remained independently associated with bronchopulmonary dysplasia.CONCLUSIONS:
the factors associated with bronchopulmonary dysplasia are related to neonatal features, asprolonged mechanical ventilation and the use of a surfactant influencethe development of thedisease.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Bronchopulmonary Dysplasia
/
Fetal Membranes, Premature Rupture
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Language:
Portuguese
Journal:
Rev. bras. ginecol. obstet
Journal subject:
Gynecology
/
Obstetrics
Year:
2010
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Oswaldo Cruz/BR