Objectives: To learn about the profile of fungal colonization and related risk factors in premature newborns. Methods:Prospective cohort, from 04/01/2010 to 04/31/2011, with 44 patients admitted to the neonatal intensive care unit, born at the hospital maternity, weighing less than 1,500 g. On admission, data were collected on pre-natal care and childbirth. Clinical and laboratory information, nasal and rectal swabs, and peripheral blood cultures were collected on days 1,7,10 and 14 of stay in neonatal intensive care unit and then, every 7 days until discharge or death. For statistical analysis, we used chi-square test, Fisher exact test, Kaplan-Meier and logistic regression model. Results:The incidence of colonization was 13.5/1,000 patients/ day. The incidence of candidemia was 0.9/1,000 patients/day. The average hospitalization time was 30.5 days (± 20.27), and the onset of colonization occurred, in average, at 11.13 days (±8.82). Vaginal delivery was found to be an independent risk factor for the development of fungal colonization during hospitalization (p = 0.042, odds ratio = 4.38, 95% confidence interval [95%CI] = 1,13-16,99). Likewise, leukocytosis (> 30,000/mm 3 ) on admission was an indicator for the simultaneous presence of fungal colonization (p = 0.048). The presence of bronchopulmonary dysplasia tends to be a factor of higher probability for the development of colonization (p = 0.067). The most affected colonization site was the rectal mucosa: 89.09 versus 10.9% of the nasal mucosa. Conclusion:Vaginal delivery and leukocytosis over 30,000/mm 3 on admission were found to be risk factors for fungal colonization during hospitalization.J Pediatr (Rio J). 2012;88(3):211-6: Candidiasis, candidemia, prematurity, Neonatal Intensive Care Unit. ResumoObjetivos: Conhecer o perfil de colonização fúngica e os fatores de risco associados em recém-nascidos prematuros.Métodos: Coorte prospectiva, de 01/04/10 a 31/04/11, com 44 pacientes admitidos na unidade de terapia intensiva neonatal, nascidos na maternidade do hospital, com peso menor que 1.500 g. Na admissão, coletaram-se dados sobre pré-natal e parto. Informações clínico-laboratoriais, swabs nasal, retal e hemocultura periférica foram coletados nos dias 1, 7, 10 e 14 de permanência na unidade de terapia intensiva neonatal e, então, a cada 7 dias até alta ou óbito. Para análise estatística, utilizou-se teste qui-quadrado, exato de Fisher, curva de Kaplan-Meier e modelo de regressão logística.Resultados: A incidência de colonização foi de 13,5/1.000 pacientes/dia. A de candidemia foi de 0,9/1.000 paciente/dia. A média de internamento foi de 30,5 dias (±20,27), sendo o início da colonização, em média, aos 11,13 dias (±8,82). O parto vaginal foi um fator de risco independente para desenvolvimento de colonização fúngica ao longo da internação [p = 0,042; odds ratio = 4,38; intervalo de confiança de 95% (IC95%) = 1, [13][14][15][16]99]. Da mesma forma, a leucocitose (> 30.000/mm 3 ) na admissão foi um sinalizador para a presença concomitante de colonização...

Objective To develop reference curves of estimated fetal weight for a local population in Curitiba, South of Brazil, and compare them with the curves established for other populations. Methods An observational, cross-sectional, retrospective study was conducted. A reference model for estimated fetal weight was developed using a local sample of 2,211 singleton pregnancies with low risk of growth disorders and well-defined gestational age. This model was compared graphically with the Hadlock and Intergrowth 21st curves. Results Reference curves for estimated fetal weight were developed for a local population. The coefficient of determination was R2 = 99.11%, indicating that 99.11% of the fetal weight variations were explained by the model. Compared with Hadlock curves, the 50th, 90th, and 97th percentiles in this model were lower, whereas the 10th percentile nearly overlapped, and the 3rd percentile was slightly higher in the proposed model. The percentiles were higher in the proposed model compared with the Intergrowth 21st curves, particularly for the 3rd, 10th, and 50th percentiles. Conclusion We provide a local reference curve for estimated fetal weight. The proposed model was different from other models, and these differences might be due to the use of different populations for model construction.

Purpose: To compare the performance of a local estimated fetal weight curve with curves established for other populations to predict small for gestational age (SGA) fetuses.Methods: A retrospective and cross-sectional study involving 231 fetuses in which the performance of a local curve (proposed model) was compared with the Hadlock and Intergrowth-21st curves in the prediction of SGA fetuses, by applying them to a population of high-risk pregnant woman with HIV/AIDS. For each model, a receiver operating characteristic curve was adjusted, considering the SGA classification by the neonatal Intergrowth method as the gold standard, and the area under the curve (AUC) was calculated.Results: The models presented linear correlations with each other. The agreement of the proposed model with Hadlock was very good (kappa = 0.83), whereas the proposed model and Intergrowth-21st had moderate agreement (kappa = 0.44). The SGA fetus detection sensitivities of the proposed model and Hadlock were 61.9% and 57.1%, with specificity of 84.1% and 86.2% and accuracy of 80.1% and 81%, respectively, without statistical difference. The sensitivity of the Intergrowth-21st model was 33.3%, while the accuracy was 85.7% and the specificity was 97.4%. The AUC estimated values for the Hadlock, proposed, and Intergrowth-21st models were 0.834, 0.832, and 0.835, respectively. Conclusion:The proposed model and Hadlock were interchangeable in the prediction of SGA fetuses and superior to the Intergrowth-21st model.