ResumoObjetivo: Avaliar a eficácia terapêutica de um sistema de fototerapia microprocessada que utiliza diodos emissores de luz (Super LED) de alta intensidade no tratamento da hiperbilirrubinemia em recém-nascidos prematuros.Métodos: Ensaio clínico, randomizado e controlado, utilizando a fototerapia Super LED no grupo experimental e duas fototerapias halógenas no grupo controle. A randomização foi realizada em blocos e estratificada por peso de nascimento. A duração da fototerapia e a queda nos níveis séricos de bilirrubina total nas primeiras 24 horas de tratamento foram os principais desfechos analisados. Conclusions: Our results demonstrate that the efficacy of Super LED phototherapy for treating hyperbilirubinemia in premature infants was significantly better than halogen phototherapy.J Pediatr (Rio J). 2007;83(3):253-258: Neonatal hyperbilirubinemia, phototherapy.

extrauterine growth restriction was high in the population, especially for SGA newborns and those with neonatal morbidities.

Suggested citation: de Carvalho M, Gomes MA. Mortality of very low birth weight preterm infants in Brazil: reality and challenges. J Pediatr (Rio J). 2005;81(1 Suppl):S111-S118. AbstractObjective: The objective of this article is to review and discuss the medical literature on epidemiological indicators and organizational structure of the Brazilian perinatal health system concerning the care of very low birth weight premature infants (< 1,500 g).Sources of data: Electronic search of the MEDLINE, Lilacs and SciELO databases from 1990 to 2004, with a selection made of the most relevant articles. Documents and reports from the Ministry of Health (Mortality Information System SIM and Live Births Information System SINASC). Summary of the findings:The decrease in infant mortality rates and the high incidence of maternal deaths, observed since 1990, prompted de Brazilian government to focus its strategies on the organization and delivery of care to pregnant women and their newborn infants. However, a critical analysis of the actions aimed at the care of premature infants reveals that the coverage and utilization of these services are not uniform and that the records on birth and death rates are not reliable. The availability of neonatal beds is very limited and does not meet the demand, especially for those requiring high levels of complexity. Important challenges must be overcome to adequately deal with the incorporation of inappropriate technology, the limited number of qualified health professionals and utilization of evidence-based best practices to improve perinatal care. Conclusions:A reduction in the rates of morbidity and mortality of premature infants requires more effective planning and intervention in the prenatal care system. To meet the demand, increases in the number of neonatal intensive care beds should be implemented through specialized perinatal centers rather than isolated beds within hospitals of with low resolution rates. These centers should be interconnected and their practices constantly monitored and evaluated.J Pediatr (Rio J). 2005;81(1 Suppl):S111-S118: Neonatal mortality rate, premature infants, low birth weight, perinatal care.

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