Morbidade respiratória no primeiro ano de vida de prematuros egressos de uma unidade pública de tratamento intensivo neonatal

Abstract

Objective: The objective of this study was to verify the incidence of respiratory morbidity in the first year of life in very low birth weight preterm infants and also to compare the presence of respiratory morbidity in the first year of life according to neonatal risk factors.Methods: This is a prospective cohort study. We studied preterm newborn infants weighing less than 1,500 g and with gestational age less than 34 weeks who were born between 1998 and 2000. During the first year of life, the infants received monthly medical follow-up and during each visit we evaluated the patients considering the presence of obstructive airway syndrome and/or pneumonia and/or hospital admission due to respiratory conditions. The incidence rate of respiratory morbidity in the first year of life was measured. Chi-squared test was used to compare proportions. Results:The cohort was constituted of 97 preterm infants with mean birthweight of 1,113 g and mean gestational age of 28 weeks. The incidence rates of obstructive airway syndrome, pneumonia and hospital admission were 28, 36 and 26%, respectively. The incidence rate of respiratory morbidity was 53%. There was a significant difference between the incidence rates of respiratory morbidity among infants who had a prolonged use of oxygen (83%) and those who did not (43%). Conclusion:More than 50% of the infants presented respiratory morbidity in the first year of life and there was a high percentage of pneumonia and hospitalization due to respiratory conditions. Infants who had a prolonged use of oxygen presented with higher respiratory morbidity incidence rate than infants who did not use oxygen for a long period.J Pediatr (Rio J). 2004;80(6):503-10: Respiratory morbidity; very low birthweight, preterm infant, follow-up.

Pacing Opportunities at Home and Skill of Children With Potential Changes in Functional Development

“…However, it was observed that more than two thirds of home environments surveyed had medium or high level of stimulation in AHEMD-Total and good or very good opportunities in the dimensions of variety (if the child plays with other children, if choose their toys, if games are stimulated by parents, type of clothing to play, and the time it remains in certain environments) and inner space (presence of apparatuses, internal surfaces and internal space for existing games at home). Opportunities for home environment stimuli are the main catalysts of learning to many children, for being the location where they spend most of the time and allow the experience of different sensorimotor experiences 23,24 . Thus, it seems that participants had favorable conditions for development of functional mobility skills, which reflected in their performance, which remained within the normal range (PEDI normative score).…”

“…According to Mello, Dutra and Lopes 23 , respiratory disorders are common in premature infants and are important factor for mortality and morbidity in childhood, accounting for recurrent hospitalizations in the first years of life. It is common to observe that most of parents, in order to avoid the disease exacerbation, have excess care, leading to a sort of limitation on motor experiences that can impair the process of developing and refining the functional abilities 27 .…”

Fatores associados à morbidade respiratória entre 12 e 36 meses de vida de crianças nascidas de muito baixo peso oriundas de uma UTI neonatal pública

“…A rotina de acompanhamento das crianças durante o primeiro ano de vida foi mensal 8,9 , as informações referentes ao período (variáveis só-cio-demográficas, maternas, neonatais e pós-neonatais) foram publicadas previamente 7,8,9 enquanto o acompanhamento, a partir de 12 meses de vida, se caracterizou por consultas trimestrais. A cada consulta trimestral realizada eram coletadas as fichas com registros dos responsáveis sobre a presença de intercorrências respiratórias ocorridas desde a última consulta até a consulta atual, portanto, se a consulta ocorreu no trimestre imediatamente anterior, o registro seria referente a um período de observação de três meses.…”

“…Fatores como: uso de ventilação mecânica, pneumonia neonatal e alteração na função pulmonar apresentaram importante repercussão na incidência de morbidade respiratória no primeiro ano de vida de crianças nascidas prematuras 7,8,9 , porém no nosso meio ainda é pouco conhecido se a morbidade respiratória nessas crianças se ARTIGO ARTICLE mantém elevada e se tal associação se mantém relevante em relação à morbidade respiratória na infância, entre 1 e 3 anos de vida.…”

Bronchopulmonary dysplasia prediction model for 7-day-old infants

“…A displasia broncopulmonar (DBP) ainda é a morbidade mais comum em recém-nascidos (RN) de extremo baixo peso, embora a incidência, os fatores de risco e a gravidade dessa doença tenham se modificado substancialmente após a introdução de novas terapias e técnicas de ventilação mecânica [1][2][3] . Sua patogênese é multifatorial e inclui imaturidade, infecção, baro/volutrauma e toxicidade pelo uso do oxigênio.…”