Gray zone: mortality profile of newborns at the limit of viability

Carvalho, Werther Brunow de; Matsushita, Felipe Yu; Krebs, Vera Lúcia Jornada

doi:10.1590/1806-9282.65.9.1128

Cited by 25 publications

(5 citation statements)

References 8 publications

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“…13 The interval between 23 and 24 weeks of gestational age is called the gray zone because there are not enough factors to determine a survival prognosis; the decision to resuscitate or not these premature babies depends on the parents' wishes. 20 There were no records on this aspect in the medical charts.…”

Section: Discussionmentioning

confidence: 99%

“…This is inconsistent with the results of a study conducted in the United States (USA), which defined the viability of PNs between 20 and 25 weeks. The GA continues to be the determining factor on the limit of viability, since no precise factors on the prognosis of extreme PNs have been identified.. 20 Need for vasoactive drugs 1(50%) Limit of viability of extremely preterm infants treated at a university hospital 6…”

Section: Discussionmentioning

confidence: 99%

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Limit of viability of extremely preterm infants treated at a university hospital / Limite de viabilidade de prematuros extremos atendidos em um hospital universitário

Vasconcelos

Silva

Souza

et al. 2023

RPCF

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Objetivo: descrever o perfil de recém-nascidos com prematuridade extrema e identificar fatores associados a mortalidade segundo idade gestacional e o limite de viabilidade destes. Método: estudo observacional retrospectivo, com abordagem quantitativa, realizado em um hospital universitário do estado de Minas Gerais, desenvolvido de agosto de 2021 a janeiro de 2022. A amostra foi composta por 39 prontuários de prematuros extremos nascidos vivos. Foi realizada a análise descritiva das variáveis quantitativas usando medidas como média, desvio-padrão e valores mínimo e máximo. As variáveis categóricas foram descritas a partir de suas distribuições de frequência absoluta e percentual. Resultados: a maioria das gestantes são mulheres adultos-jovens, realizaram pré-natal e parto cesárea. Dos prematuros prevalece sexo masculino, idade gestacional de 25 semanas, evoluíram para óbito a maioria destes com idade gestacional de 23 e 24 semanas. Conclusão: o limite de viabilidade nesse serviço situa-se em uma idade gestacional igual ou maior que 25 semanas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Limit of viability of extremely preterm infants treated at a university hospital / Limite de viabilidade de prematuros extremos atendidos em um hospital universitário

Vasconcelos

Silva

Souza

et al. 2023

RPCF

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“…The population consisted of all preterm infants with GA until 31 weeks, admitted to the institution between August 2015 and August 2020, who had a lethal outcome. Newborns with severe malformations (cardiac, pulmonary, cerebral, gastrointestinal), sufficient to cause greater morbidity, were excluded (Carvalho et al, 2019;Castro et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

Detecção de possíveis novos produtos gênicos em Bifidobacterium breve DS15-17 por análises in silico

Damasceno¹,

Santos²,

Oliveira³

et al. 2024

Contribuições Das Ciências Da Saúde Para O Mundo

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Prezados (as) leitores (as), o presente livro trata-se de uma coletânea de pesquisas sobre os mais diversos e variados temas que fazem parte da área da saúde, desde suas indagações, até os problemas e soluções encontradas nesses. Ademais, espero que encontre frutíferas elucidações e indagações feitas. Para alguns autores o conhecimento é como um oceano a noite em que o leitor utilizando um barco e uma lanterna vê partes de um infinito mar que não tem fim, por meio de livros, mestres e pessoas que passam em seu caminho. Deste modo, portanto, esperamos que parte desse livro traga novas descobertas, tais quais como maravilhas em um oceano desconhecido para um viajante empolgado. SUMÁRIOAumento da prevalência de puberdade precoce: qual a influência de disruptores endócrinos?

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“…We decided to include every case from 20 weeks because the definition of placental abruption is possible at a gestational age > 20 weeks [19] and the lower gestational age limit for viability is still uncertain, indeed between 20 and 25 weeks there is a gray area with up to 50% of survival rate [20].…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Neonatal/Maternal Morbidity and Mortality in African American Women with Placental Abruption

et al. 2020

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Background and Objectives: Risk factors for neonatal/maternal morbidity and mortality in placental abruption have been incompletely studied in the current literature. Most of the research overlooked the African American population as mostly Caucasian populations are selected. We aimed to find which risk factor influence the neonatal and maternal outcome in cases of placental abruption occurring in African American pregnant women in an inner-city urban setting. Materials and Methods: We performed a retrospective cohort study at St. Joseph’s Regional Medical Center, NJ United States of America (USA), between 1986 and 1996. Inclusion criteria were African American race, singleton pregnancy with gestational age over 20 weeks and placental abruption. Maternal age, gravidity, parity, gestational age at delivery/occurrence of placental abruption and mode of delivery were collected. Risk factors for placental abruption such as placenta previa, hypertensive disorders of pregnancy, cigarette smoking, crack/cocaine and alcohol use, mechanical trauma, preterm premature rupture of membranes (PPROM), and premature rupture of membranes (PROM) were recorded. Poor neonatal outcome was considered when anyone of the following occurred: 1st and 5th minute Apgar score lower than 7, intrauterine fetal demise (IUFD), perinatal death, and neonatal arterial umbilical cord pH less than 7.15. Poor maternal outcome was considered if any of the following presented at delivery: hemorrhagic shock, disseminated intravascular coagulation (DIC), hysterectomy, postpartum hemorrhage (PPH), maternal intensive care unit (ICU) admission, and maternal death. Results: A population of 271 singleton African American pregnant women was included in the study. Lower gestational age at delivery and cesarean section were statistically significantly correlated with poor neonatal outcomes (p = 0.018; p < 0.001; p = 0.015) in the univariate analysis; only lower gestational age at delivery remained significant in the multivariate analysis (p = < 0.001). Crack/cocaine use was statistically significantly associated with poor maternal outcome (p = 0.033) in the univariate analysis, while in the multivariate analysis, hemolysis, elevated enzymes, low platelet (HELLP) syndrome, crack/cocaine use and previous cesarean section resulted significantly associated with poor maternal outcome (p = 0.029, p = 0.017, p = 0.015, p = 0.047). PROM was associated with better neonatal outcome in the univariate analysis, and preeclampsia was associated with a better maternal outcome in the multivariate analysis. Conclusions: Lower gestational age at delivery is the most important risk factor for poor neonatal outcome in African American women with placental abruption. Poor maternal outcome correlated with HELLP syndrome, crack/cocaine use and previous cesarean section. More research in this understudied population is needed to establish reliable risk factors and coordinate preventive interventions.

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Gray zone: mortality profile of newborns at the limit of viability

Cited by 25 publications

References 8 publications

Limit of viability of extremely preterm infants treated at a university hospital / Limite de viabilidade de prematuros extremos atendidos em um hospital universitário

Limit of viability of extremely preterm infants treated at a university hospital / Limite de viabilidade de prematuros extremos atendidos em um hospital universitário

Detecção de possíveis novos produtos gênicos em Bifidobacterium breve DS15-17 por análises in silico

Risk Factors for Neonatal/Maternal Morbidity and Mortality in African American Women with Placental Abruption

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