Objective: To determine maternal and fetal risk factors associated with the birth of late preterm infants in comparison to those born at term. Methods: A case-control study was carried out in a tertiary center for high-risk pregnancies. For the cases, the study enrolled post-partum mothers and their respective newborns with gestational ages equal or greater than 34 weeks and less than 37 weeks. As controls, the post-partum mothers and their newborns with gestational ages of 37 weeks or greater were selected. The sample was calculated with a ratio of two controls for each case, resulting in 423 patients. Association studies were performed using the chi-square test or Fisher’s exact test and logistic regression analysis. Results: The variables associated with late prematurity were inadequate prenatal (Odds Ratio [OR] 1.23; confidence interval of 95% [95%CI] 1.12-1.34; p≤0.001), premature rupture of membranes (OR 4.98; 95%CI 2.66-9.31; p≤0.001), length of hospital stay ≥24 hours until birth (OR 0.18; 95%CI 0.06-0.52; p≤0.001), cesarean section (OR 2.74; 95%CI 1.69-4.44; p≤0.001) and small for gestational age newborn (OR 3.02; 95%CI 1.80-5.05; p≤0.001). Conclusions: Inadequate prenatal care and membranes’ premature rupture were found as factors associated with the late preterm birth. It is important to identify the factors that allow intervention with adequate prenatal care in order to reduce poor outcomes due to late prematurity.

Background: Recommended by the World Health Organization, exclusive breastfeeding is a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the severe acute respiratory syndrome coronavirus 2. Despite the Brazilian national Guideline protecting breastfeeding practice, there are many concerns about protecting babies from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods: This is a descriptive cross-sectional and multicenter study collecting data from 24 Brazilian hospitals and maternity services from March to July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations.Results: The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact and companions for the mother and did not support mothers to initiate breastfeeding in the first hour. In rooming-in, 98.5% of the services allowed breastfeeding and recommend care for babies following the respiratory hygiene practices to prevent transmission of COVID-19 and whether companions are forbidden (83.3%). Hospital discharge was mostly early (79.1%); the guidelines were not individualized. Additionally, a lack of support was noticed from the health community network in the home environment (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). Conclusions: In Brazil, the hospitals are not able to approach recommendations to protect, promote, and support breastfeeding properly during the COVID-19 outbreak. The scientific community needs to discuss how to improve maternal and baby care services to protect breastfeeding in the current pandemic.

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Objetivo: Avaliar as condutas dos neonatologistas na Unidade de Terapia Intensiva Neonatal (UTIN), frente aos neonatos sem possibilidades curativas, comparando com as características sociodemográficas dos profissionais e à existência de diretrizes/protocolos nas UTIN, em Santa Catarina (SC) no ano de 2021. Métodos: Trata-se de um estudo transversal realizado com os neonatologistas das UTIN de SC, no período de março a junho de 2021. A coleta de dados foi realizada através de um questionário eletrônico, construído em escala Likert (n=110). O Teste de Correlação de Spearman foi usado para determinar se a variável conhecimento sobre os cuidados paliativos (CP) neonatais diferia estatisticamente pelas visões, práticas e características sociodemográficas dos participantes da pesquisa, adotando-se nível de significância p ≤ 0,05. Resultados: Do total de participantes, 100% afirmaram a necessidade de obrigatoriedade do treinamento de CP durante a residência médica, 85,5% revelaram divergências na aplicação dos CP, 46,4% consideraram não haver um ambiente propício de UTIN para o fornecimento dos CP, 70% afirmaram que a participação dos pais nas decisões sobre os CP não ocorre. O uso de protocolo nas UTIN (Rho= -0,332) e confiança na aplicação dos CP (Rho= -0,375) apresentaram correlação negativa com a frequência de aplicação dos CP. Conclusão: A frequência de aplicação dos CP influenciou na confiança, no uso de diretrizes e em menos divergências no fornecimento desse cuidado. Ademais, a falta de confiança, de diretrizes e de UTIN com ambiente adequado ratificaram a necessidade de medidas que preencham as lacunas do paliativismo neonatal.