Abstract
Rev Bras Ter Intensiva. 2012;24(4):386-392
DOI 10.1590/S0103-507X2012000400016
OBJECTIVE: To analyze the process of care provided to premature infants in a neonatal intensive care unit and the factors associated with their mortality. METHODS: Cross-sectional retrospective study of premature infants in an intensive care unit between 2008 and 2010. The characteristics of the mothers and premature infants were described, and a bivariate analysis was performed on the following characteristics: the study period and the "death" outcome (hospital, neonatal and early) using Pearson's chi-square test, Fisher's exact test or a chi-square test for linear trends. Bivariate and multivariable logistic regression analyses were performed using a stepwise backward logistic regression method between the variables with p<0.20 and the "death" outcome. A p value <0.05 was considered to be significant. RESULTS: In total, 293 preterm infants were studied. Increased access to complementary tests (transfontanellar ultrasound and Doppler echocardiogram) and breastfeeding rates were indicators of improving care. Mortality was concentrated in the neonatal period, especially in the early neonatal period, and was associated with extreme prematurity, small size for gestational age and an Apgar score <7 at 5 minutes after birth. The late-onset sepsis was also associated with a greater chance of neonatal death, and antenatal corticosteroids were protective against neonatal and early deaths. CONCLUSIONS: Although these results are comparable to previous findings regarding mortality among premature infants in Brazil, the study emphasizes the need to implement strategies that promote breastfeeding and reduce neonatal mortality and its early component.
Abstract
Rev Bras Ter Intensiva. 2011;23(3):370-373
DOI 10.1590/S0103-507X2011000300016
Although low-birth neonates are acknowledged to experience pain, many routine procedures continue to be conducted without proper pharmacological or non-pharmacological analgesia. Kangaroo care is a low-cost strategy that can be used in the preterm newborn. Mothers should be encouraged to use this easy-to-perform method, which is feasible both before and during neonatal units' invasive procedures, therefore contributing to pain reduction