Adesão dos profissionais de saúde a práticas pré- e neonatais de redução da mortalidade neonatal: 2004 versus 2012

Freitas, Renata Jaccottet; Munhoz, Tiago N.; Santos, Iná da Silva dos; Chiuchetta, Flávio S.; Barros, Fernando C.; Coletto, Aline; Matijasevich, Alícia

doi:10.1590/1980-5497201600040002

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…After the diagnosis was made, all patients were tested for concentrations of the analyzed markers, after which they were treated according to a single tocolytic procedure with the use of intravenous fenoterol infusion 0.05 mg/hour during 48 hours along with glucocorticosteroid therapy (2 doses of betamethasone 12 mg every 24 hours). According to the guidelines [ 6 – 8 ], after treatment, the patients were prepared for preterm birth. Peripheral blood samples were collected into a serum separating tube (Becton Dickinson, USA; Barricore tube with mechanical separator and lithium heparin for plasma separation) and after centrifugation with the use 1000 ×g for 5 min.…”

Section: Methodsmentioning

confidence: 99%

Cytokines in Preterm Delivery: Proposal of a New Diagnostic Algorithm

Raba

Tabarkiewicz

2018

Journal of Immunology Research

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Predicting preterm delivery within 7 days is very important for the proper timing of glucocorticosteroid administration. If within 7 days after glucocorticosteroid administration, the delivery does not occur, it remains questionable if repeated glucocorticosteroid therapy results in improved infant respiratory function. Therefore, differentiation of preterm delivery from false preterm delivery is clinically significant. The aim of this study was to create a diagnostic algorithm to distinguish preterm delivery from false preterm delivery on the basis of concentrations of selected cytokines. The study group (n = 622) were patients hospitalized due to threatened preterm delivery. To assess the concentration of cytokines in the serum, we used a multiplex method, which allows simultaneous determination of 13 cytokines. The sets consist of the following cytokines: IGFBP-1, IGFBP-2, BDNF, L-Selectin, E-Selectin, ICAM-1, PECAM, VCAM-1, MIP-1d, MIP-3b, Eotaxin-1, Eotaxin-2, and BLC. In the study group, 67.8% patients had preterm delivery and 32.2% had false preterm delivery. Based on the analysis of cytokine concentrations, a classification tree to distinguish between preterm delivery and false preterm delivery was created. Our findings show the possibility of prediction of preterm delivery with the use of a classification and regression tree of selected cytokine concentration.

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Section: Methodsmentioning

confidence: 99%

Cytokines in Preterm Delivery: Proposal of a New Diagnostic Algorithm

Raba

Tabarkiewicz

2018

Journal of Immunology Research

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“…15 There was a predominance of deaths in the neonatal period -which suggests its close relationship with the provision of care during pregnancy, childbirth, and to the newborn -, which persist despite advances in perinatal care, evidencing the need for improving the quality of care in all stages. 16 In the proposed hierarchical framework, the concept of sufficient causes was employed, which considers the chronological order of events based on the hierarchization between levels and the relationship between causal factors, which in turn enables the identification of the causal chain in which interventions can be carried out. 7 The model showed an association of death with variables of the proximal level: sepsis, SNAPPE II, birth weight, and use of surfactant.…”

Section: Discussionmentioning

confidence: 99%

Snappe Ii: Analysis of Accuracy and Determination of the Cutoff Point as a Death Predictor in a Brazilian Neonatal Intensive Care Unit

Fontenele

Silva

Leite

et al. 2020

Rev. paul. pediatr.

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Objective: To analyze the accuracy of the Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II) as a death predictor, to determine the cutoff point for mortality, and to analyze the association of independent variables with death. Methods: Prospective, longitudinal, hospital-based study on newborns admitted to the Neonatal Intensive Care Unit (NICU) for the first time from November 1, 2016 to April 30, 2017. Newborns with less than 12 hours of length of stay at the NICU, out-of-hospital births, major congenital malformations, and inter-hospital transfer were excluded. Variables were grouped according to hierarchical framework, related to maternal characteristics (distal level), prenatal and childbirth care (intermediate level), and birth conditions (proximal level). Descriptive analyses of SNAPPE II score ranges, Receiver Operating Characteristics Curve (ROC curve) to define the cutoff point for mortality, and bivariate analysis by the Wald test and multiple logistic regression were conducted. Results: After selection, the sample consisted of 247 newborns. In this study, the SNAPPE II cutoff point for mortality was 27, with sensitivity of 84.1% and specificity of 82.4%. 61% of those with a score ≥27 died. Multiple logistic regression showed an association between death and proximal-level variables: sepsis (Odds Ratio [OR] 10.68; 95% confidence interval [95%CI] 2.82–40.48; p<0.001); SNAPPE II ≥27 (OR 5.85; 95%CI 1.90–18.05; p=0.002); birth weight 750–999 g (OR 4.15; 95%CI 1.06–16.14; p=0.040); and nonuse of surfactant (OR 0.159; 95%CI 0.04–0.53; p=0.003). Conclusions: Neonatal mortality was directly proportional to increase in SNAPPE II. Score≥27 increased the odds of dying by six times compared with neonates with lower scores. The proximal variables related to health conditions and neonatal care were associated with death.

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Adesão dos profissionais de saúde a práticas pré- e neonatais de redução da mortalidade neonatal: 2004 versus 2012

Abstract: At the end of the study period, rates of use of antenatal steroids and surfactant were lower than figures reported internationally. Similarly, the frequency of hypothermia at the neonatal intensive care unit admission was higher than the occurrence observed in developed countries.

Cited by 2 publications

References 24 publications

Cytokines in Preterm Delivery: Proposal of a New Diagnostic Algorithm

Cytokines in Preterm Delivery: Proposal of a New Diagnostic Algorithm

Snappe Ii: Analysis of Accuracy and Determination of the Cutoff Point as a Death Predictor in a Brazilian Neonatal Intensive Care Unit

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