Mortality in very low birth weight (VLBW) infants in the South American NEOCOSUR Neonatal Network: timing and causes

Abstract

Introduction. Mortality in very low birth weight infants (VLBWIs) has remained at ~26% in the past 16 years in the NEOCOSUR Neonatal Network. Objective. To determine the cause of death of VLBWIs and its temporality in the 2007-2016 period in the NEOCOSUR Neonatal Network.Population and methods. Observational, multicenter cohort study; retrospective analysis of data collected prospectively. Newborn infants born between 24 and 31+6 weeks of gestation age with a birth weight between 500 and 1500 g in the 26 sites of the NEOCOSUR Neonatal Network were included. The causes of death were analyzed depending on whether they occurred in the delivery room (DR) or in the neonatal intensive care unit (NICU). The postnatal age at time of death was determined using the Kaplan-Meier test. Results. A total of 11 753 VLBWIs were included; overall mortality was 25.6%. The prevailing causes of death in the DR were congenital malformations (43.3%), respiratory diseases (14.3%), and prematurity (11.4%). The prevailing causes of death in the NICU were respiratory diseases (24.2%) and infections (24.1%). The average and median age at death were 10.2 and 4 days, respectively. Also, 10.2% of deaths occurred in the DR; 21.5% on day 1, 52% in the first 4 days, and 63.8% in the first week of life. Conclusions. Important differences were observed in the causes of death of VLBWIs depending on their occurrence in the DR or the NICU. Infectious and respiratory conditions were the most relevant factors following admission to the NICU.

Método canguru: revisão histórica e documental

“…Sendo a Norma de Orientação para a Implantação do Método Canguru, ou seja, o Documento 2, talvez o documento mais importante no protagonismo para implantação dessa prática, que se propõe a promover a atenção humanizada ao recém-nascido de baixo peso que foi aprovada e regulamentada pelo Ministério da Saúde por meio da Portaria nº693, de 05 de julho de 2000 (Brasil, 2000;COREN, 2011). Sendo iniciado essa prática em alguns estados, como São Paulo (Hospital Estadual Guilherme Álvaro, cidade de Santos) e em Pernambuco (Instituto Materno Infantil de Pernambuco -IMIP, cidade de Recife (Aires et al, 2022).…”

“…Devido ao desenvolvimento incompleto do período gestacional, estas crianças costumam nascer com baixo peso - menor que 2.500g Victor;Fernandes, 2023). Sendo assim, a prematuridade é um importante problema de saúde pública, tendo em vista que nascem por ano cerca de 15 milhões de bebês pré-termos no mundo, onde o Brasil ocupa a 10ª posição entre os países com maiores taxas de nascimento prematuro (Testoni;Aires, 2018).…”

Exploring Trends in Neonatal Mortality among Infants ≤ 32 weeks Gestational Age at Birth in Latin America and the Caribbean units using the EpicLatino Network Database Compared to Canadian Neonatal Network 2022

“…For instance, a study in Singapore [4] involving three units showed no mortality differences. In South America, [5] the causes of mortality vary significantly, but they have not been studied with respect to the originating unit. It is important to highlight that mayor congenital malformations could affect mortality.…”