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...

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Detalles Bibliográficos
Autores: Martinez, Francisco E., Linhares, Nelson J., Ferlin, Maria L. S., Marba, Sérgio, Netto, Abimael A., Procianoy, Renato S., Uchoa, Natacha T., Lopes, José Maria A., Bomfim, Olga, Guinsburg, Ruth, Almeida, Maria Fernanda B., Miyoshi, Milton, Meneguel, Joice F., Leone, Cléa R., Sadeck, Lílian S. R., Vaz, Flávio A. C., Fiori, Renato M., Fiori, Humberto H., Pereira, Manuel R., Trindade, Cleide E. P. [UNESP], Betlin, Maria R. [UNESP]
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
Descripción
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.