versão On-line ISSN 1683-9803
GENES, L et al. Morbidity and Mortality in Very-Low Birth Weight Newborns Neonatology Unit. Centro Materno Infantil. Hospital de Clinicas. Pediatr. (Asunción) [online]. 2010, vol.37, n.1, pp.9-22. ISSN 1683-9803.
Introduction: Mortality among very low birth weight (VLBW) newborns contributes significantly to the overall rates of neonatal and infant mortality. With the advances that have occurred in perinatal medicine, the increased survival rate among this group has led to increased morbidity rates. With the exception of newborns who are extremely premature or who have congenital defects, death is largely avoidable with timely medical interventions of proven efficacy. Objectives: To determine the mortality and morbidity among VLBW newborns at the neonatology unit of the Centro Materno Infantil of the Hospital de Clinicas. Methodology: Prospective, descriptive, cohort study of all children born between January 1, 2004 and December 31, 2007 in the Centro Materno Infantil with a birth weight between 500 and 1500 grams, including follow up until discharge or hospital death. Results: Of a total of 9486 live births, 128 were VLBW (incidence: 1.35%). Weight was 1143±2 47 grams, and mean gestational age was 29.6±2.8 weeks. Cesarean was the delivery method for 57%, and 54% were female. Prenatal monitoring was recorded in in 86% and the use of corticosteroids was recorded 50.8%, while the primary maternal pathology was premature rupture of membrane (37.5%). Among interventions in the delivery room, resuscitation with bag and mask, at 36.7%, were the most common. We analyzed 119 newborns who received interventions, excluding delivery room deaths. The most common pathologies in newborns were respiratory distress (59.6%) and late-onset sepsis (31%). Newborns with respiratory distress received pulmonary surfactant (57.7%). Mechanical ventilation was used in 48.7%. Follow-up was done, including by transfontanellar ultrasound (75.6%) and funduscopy (42%). Overall mortality was 32.8% (42/128), while excluding those occurring in the delivery room, mortality was 27.7% (33/119). The weight range in which the greatest mortality occurred (88.9%) was 501 to 750 grams. and gestational age was 30 weeks. Mean hospital stay was 44.3±30.12 days, and the principal cause of death was sepsis (30%). Conclusions: Incidence of very low birth weight newborns in the period analyzed was 1.35%. The most common cause of morbidity was hyaline membrane disease, found in 59.6% of patients, with a mortality of 36.6%. The overall mortality rate for the group was 32.8%. The most common causes of mortality were infections, prematurity, and pulmonary hemorrhage.
Palavras-chave : Newborns; neonates; infant; very low birth weight; neonatal mortality; neonatal disease; respiratory distress syndrome; neonatal.