Silva Cristiana Ferreira da, Leite Álvaro Jorge Madeiro, Almeida Nádia Maria Girão Saraiva de, Leon Antonio Carlos Monteiro Ponce de, Olofin Ibironke
Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil, Faculdade de Medicina , Universidade Federal do Ceará , Fortaleza , Brasil .
Escola de Saúde Pública do Ceará, Fortaleza, Brasil, Escola de Saúde Pública do Ceará , Fortaleza , Brasil .
Cad Saude Publica. 2014 Feb;30(2):355-68. doi: 10.1590/0102-311X00050013.
This study aimed to identify factors associated with in-hospital mortality in High-Risk Neonatal Units (NICU) belonging to the North-Northeast Perinatal Health Network in Northeast Brazil. The explanatory variables were individual maternal characteristics, prenatal care, childbirth and neonatal care, and infant characteristics. This was a longitudinal, multicenter hospital-based study. The study population consisted of 3,623 live born infants admitted to 34 NICUs. After adjusting for the three hierarchical levels in the model for determination of death in the NICU up to the 27 th day of life, the following showed statistically significant association: type of delivery - cesarean section (OR = 0.72; 95%CI: 0.56-0.95), non-use of prenatal steroids (OR =1.51; 95%CI: 1.01-2.25), preeclampsia (OR = 0.73; 95%CI: 0.56-0.95), oligohydramnios (OR = 1.57; 95%CI: 1, 17-2.10), birth weight < 2500g (OR = 1.40; 95%CI: 1.03-1.90), 5-minute Apgar score < 7 (OR = 2.63; 95%CI: 2.21-3.14), endotracheal intubation (OR = 1.95; 95%CI: 1.31-2.91), and non-use of surfactant (OR = 0.54; 95%CI: 0.43-0.69). Death during NICU care is determined by conditions of the pregnancy, childbirth, and the newborn.
本研究旨在确定巴西东北部北-东北围产期健康网络所属高危新生儿重症监护病房（NICU）中与院内死亡相关的因素。解释变量包括产妇个体特征、产前护理、分娩及新生儿护理，以及婴儿特征。这是一项基于医院的纵向多中心研究。研究人群包括入住34个新生儿重症监护病房的3623例活产婴儿。在对出生后27天内新生儿重症监护病房死亡判定模型中的三个层次水平进行调整后，以下因素显示出具有统计学意义的关联：分娩方式——剖宫产（比值比[OR]=0.72；95%置信区间[CI]：0.56 - 0.95）、未使用产前类固醇（OR =1.51；95%CI：1.01 - 2.25）、子痫前期（OR = 0.73；95%CI：0.56 - 0.95）、羊水过少（OR = 1.57；95%CI：1.17 - 2.10）、出生体重<2500g（OR = 1.40；95%CI：1.03 - 1.90）、5分钟阿氏评分<7（OR = 2.63；95%CI：2.21 - 3.14）、气管插管（OR = 1.95；95%CI：1.31 - 2.91），以及未使用表面活性剂（OR = 0.54；95%CI：0.43 - 0.69）。新生儿重症监护病房护理期间的死亡由妊娠、分娩及新生儿的状况决定。
