摘要
Peri-intraventricular hemorrhage is one of the main causes of neurological impairment in premature newborns. </span><span style="font-family:Verdana;">To control</span><span style="font-family:""><span style="font-family:Verdana;"> their risk factors is necessary </span><span style="font-family:Verdana;">in view of</span><span style="font-family:Verdana;"> the increasing survival of </span><span style="font-family:Verdana;">extreme</span><span style="font-family:Verdana;"> preterm infants</span></span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">Objective:</span><span style="font-family:""><span style="font-family:Verdana;"> To </span><span style="font-family:Verdana;">evaluate the prevalence of peri-intraventricular hemorrhage in premature newborns, identify the risk factors and observe the frequencies of intra-hospital </span><span style="font-family:Verdana;">outcomes of </span><span style="font-family:Verdana;">interests</span><span style="font-family:Verdana;">. </span><span><span style="font-family:Verdana;">Methods:</span><i> </i></span></span><span style="font-family:Verdana;">This study was done in Brazil</span><span style="font-family:""><span style="font-family:Verdana;">. This was an observational, analytical longitudinal </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prospective study. The subjects inc</span><span style="font-family:Verdana;">luded were newborns of gestational age less than 34 weeks who were admitted to two public hospitals between May and November 2015. To assess possible</span><span style="font-family:Verdana;"> associated factors, obstetric, perinatal </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> neonatal data were analyzed (chorioamnionitis, antenatal corticosteroids, gestational age, newborn weight, Apgar score at 1 and 5 minutes, resuscitation in the delivery room, surfactant in the delivery room, newborn transferred from another hospital, respiratory distress syndrome</span></span><span style="font-family:Verdana;">:</span><span style="font-family:""><span style="font-family:Verdana;"> RDS, sepsis, umbilical vein catheterization, assisted ventilation, exogenous surfactant in the Neonatal ICU, use of sodium bicarbonate, inotropic agents, adrenaline, volume expanders </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> blood products). The hospital outcomes studied were assisted ventilation time, hospital stay </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> death. The data analysis was performed by chi-square test or Fisher’s test, with a significance level of 5%. </span><span><span style="font-family:Verdana;">Results:</span><i> </i></span><span style="font-family:Verdana;">Out of 156 newborns, 46 (29.9%) presented peri-intraventricular hemorrhage and 28.2% of these had a severe form of the disease. There were significant associations (p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.05) with the following risk factors: gestational age, birth weight, low Apgar score, delivery room resuscitation, RDS, surfactant use, sepsis, packed red blood cell transfusion, mechanical ventilation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> umbilical vein catheterization</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> The newborns with peri-intraventricular hemorrhage presented longer times on assisted ventilation, longer hospital stays </span><span style="font-family:Verdana;">and</span> <span style="font-family:Verdana;">higher</span><span style="font-family:Verdana;"> risk of death. </span><span style="font-family:Verdana;">Conclusion:</span><span style="font-family:Verdana;"> The prevalence of peri-intraventricular hemorrhage was high in the population studied, especially </span><span style="font-family:Verdana;">the</span><span style="font-family:Verdana;"> severe form. Perinatal and neonatal risk factors were associated with a higher risk of developing the disease and the outcomes studied were more evident in these newborns.
Peri-intraventricular hemorrhage is one of the main causes of neurological impairment in premature newborns. </span><span style="font-family:Verdana;">To control</span><span style="font-family:""><span style="font-family:Verdana;"> their risk factors is necessary </span><span style="font-family:Verdana;">in view of</span><span style="font-family:Verdana;"> the increasing survival of </span><span style="font-family:Verdana;">extreme</span><span style="font-family:Verdana;"> preterm infants</span></span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">Objective:</span><span style="font-family:""><span style="font-family:Verdana;"> To </span><span style="font-family:Verdana;">evaluate the prevalence of peri-intraventricular hemorrhage in premature newborns, identify the risk factors and observe the frequencies of intra-hospital </span><span style="font-family:Verdana;">outcomes of </span><span style="font-family:Verdana;">interests</span><span style="font-family:Verdana;">. </span><span><span style="font-family:Verdana;">Methods:</span><i> </i></span></span><span style="font-family:Verdana;">This study was done in Brazil</span><span style="font-family:""><span style="font-family:Verdana;">. This was an observational, analytical longitudinal </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prospective study. The subjects inc</span><span style="font-family:Verdana;">luded were newborns of gestational age less than 34 weeks who were admitted to two public hospitals between May and November 2015. To assess possible</span><span style="font-family:Verdana;"> associated factors, obstetric, perinatal </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> neonatal data were analyzed (chorioamnionitis, antenatal corticosteroids, gestational age, newborn weight, Apgar score at 1 and 5 minutes, resuscitation in the delivery room, surfactant in the delivery room, newborn transferred from another hospital, respiratory distress syndrome</span></span><span style="font-family:Verdana;">:</span><span style="font-family:""><span style="font-family:Verdana;"> RDS, sepsis, umbilical vein catheterization, assisted ventilation, exogenous surfactant in the Neonatal ICU, use of sodium bicarbonate, inotropic agents, adrenaline, volume expanders </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> blood products). The hospital outcomes studied were assisted ventilation time, hospital stay </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> death. The data analysis was performed by chi-square test or Fisher’s test, with a significance level of 5%. </span><span><span style="font-family:Verdana;">Results:</span><i> </i></span><span style="font-family:Verdana;">Out of 156 newborns, 46 (29.9%) presented peri-intraventricular hemorrhage and 28.2% of these had a severe form of the disease. There were significant associations (p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.05) with the following risk factors: gestational age, birth weight, low Apgar score, delivery room resuscitation, RDS, surfactant use, sepsis, packed red blood cell transfusion, mechanical ventilation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> umbilical vein catheterization</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> The newborns with peri-intraventricular hemorrhage presented longer times on assisted ventilation, longer hospital stays </span><span style="font-family:Verdana;">and</span> <span style="font-family:Verdana;">higher</span><span style="font-family:Verdana;"> risk of death. </span><span style="font-family:Verdana;">Conclusion:</span><span style="font-family:Verdana;"> The prevalence of peri-intraventricular hemorrhage was high in the population studied, especially </span><span style="font-family:Verdana;">the</span><span style="font-family:Verdana;"> severe form. Perinatal and neonatal risk factors were associated with a higher risk of developing the disease and the outcomes studied were more evident in these newborns.
作者
Ana Frante de Holanda Pinto Vasconcelos
Kaliny da Silva Galvão
Rodrigo Daudt Tenório
Ana Clara Monteiro Laranjeira
Délia Maria de M. L. Herrmann
Diêgo Lucas Ramos e Silva
Juliana Barbosa Nunes Cavalcante
Jamille Campos Sousa
Euclides Maurício Trindade Filho
Ana Frante de Holanda Pinto Vasconcelos;Kaliny da Silva Galvão;Rodrigo Daudt Tenório;Ana Clara Monteiro Laranjeira;Délia Maria de M. L. Herrmann;Diêgo Lucas Ramos e Silva;Juliana Barbosa Nunes Cavalcante;Jamille Campos Sousa;Euclides Maurício Trindade Filho(Biological Science Nucleus, Cesmac University Center, Maceió, Alagoas, Brasil;Biological Science Nucleus, State University of Health Science of Alagoas-UNCISAL, Maceió, Alagoas, Brasil;Department of Biological Science, Federal University of Alagoas, Maceió, Alagoas, Brasil)
