Uso antenatal de corticosteóide e evolução clínica de recém-nascidos pré-termo
Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonat...
| Autores: | , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2004 |
| País: | Brasil |
| Institución: | Universidade Estadual Paulista (UNESP) |
| Repositorio: | Repositório Institucional da UNESP |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.unesp.br:11449/67793 |
| Acceso en línea: | http://dx.doi.org/10.2223/1200 http://hdl.handle.net/11449/67793 |
| Access Level: | acceso abierto |
| Palabra clave: | Antenatal glucocorticoids Infection Low birth weight Mechanical ventilation Prematurity antibiotic agent betamethasone corticosteroid dexamethasone indometacin surfactant uterus spasmolytic agent adult analysis of variance Apgar score artificial ventilation birth chi square test clinical trial cohort analysis controlled clinical trial controlled study delivery room disease course evaluation female follow up gestational age high birth weight human hyaline membrane disease infant interview major clinical study maternal hypertension medical record multivariate logistic regression analysis necrotizing enterocolitis newborn newborn sepsis oxygenation pregnancy prematurity prenatal period rank sum test scoring system Student t test adolescent blood health care quality infection male multicenter study prenatal care prospective study statistical model Adolescent Adrenal Cortex Hormones Adult Apgar Score Cohort Studies Female Humans Infant, Newborn Infant, Premature Logistic Models Male Pregnancy Prenatal Care Prospective Studies Quality of Health Care Respiratory Therapy |
| Sumario: | Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Results: Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time, being related to increased occurrence of neonatal sepsis. Conclusions: The use of corticosteroid was associated with better prenatal care and birth conditions, better preterm evolution but higher risk of infection. Copyright © 2004 by Sociedade Brasileira de Pediatria. |
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