Avaliação dos fatores perinatais que interferem na incidência de enterocolite necrosante em recém-nascidos de muito baixo peso

Vieira, Alan Araújo; David, Bruna Bianca Lopes; Lino, Renata Rodrigues Garcia; Duarte, Luciana de Barros; Bueno, Arnaldo Costa

doi:10.1590/s0100-72032013000800005

Cited by 7 publications

(9 citation statements)

References 22 publications

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“…The literature is conflicting about the effects of pre-eclampsia and the development of retinopathy of prematurity (ROP), one of the main causes of childhood blindness worldwide. No differences in the diagnosis of ROP between groups were observed in this study [ 32 ]. Retinopathy of prematurity is initially manifested with delayed physiological vascular development of the retina, followed by aberrant vasoproliferation, and is highly correlated with extreme prematurity and low postnatal growth [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 85%

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Moura¹,

Margotto²,

Costa

et al. 2021

PLoS ONE

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Objective The present study seeks to assess the impact of gestational hypertensive disorders on premature newborns below 34 weeks and to establish the main morbidities and mortality in the neonatal period and at 18 months. Materials and methods A retrospective observational study was carried out with 695 premature newborns of gestational age (GA) between 24 and 33 weeks and 6 days, born alive in the Neonatal ICU of Brasília’s Mother and Child Hospital (HMIB), in the period from January 1, 2014, to July 31, 2019. In total, 308 infants were born to hypertensive mothers (G1) and 387 to normotensive mothers (G2). Twin pregnancies and diabetic patients with severe malformations were excluded. Outcomes during hospitalization and outcomes of interest were evaluated: respiratory distress syndrome (RDS), brain ultrasonography, diagnosis of bronchopulmonary dysplasia (BPD), diagnosis of necrotizing enterocolitis, retinopathy of prematurity, breastfeeding rate at discharge, survival at discharge and at 18 months of chronological age and relationship between weight and gestational age. Results Newborns with hypertensive mothers had significantly lower measurements of birth weight and head circumference. The G1 group had a higher risk small for gestational age (OR 2.4; CI 95% 1.6–3.6; p <0.00), as well as a greater risk of being born with a weight less than 850 g (OR 2.4; 95% CI 1.2–3.5; p <0.00). Newborns of mothers with hypertension presented more necrotizing enterocolitis (OR 2.0; CI 95% 1.1–3.7); however, resuscitation in the delivery room and the need to use surfactant did not differ between groups, nor did the length of stay on mechanical ventilation, or dependence on oxygen at 36 weeks of gestational age. Survival was better in newborns of normotensive mothers, and this was a protective factor against death (OR 0.7; 95% CI 0.5–0.9; p <0.01). In the follow-up clinic, survival at 18 months of chronological age was similar between groups, with rates of 95.3% and 92.1% among hypertensive and normotensive mothers, respectively. Exclusive breastfeeding at discharge was 73.4% in the group of hypertensive women and 77.3% in the group of normotensive mothers. There were no significant differences between groups. Conclusion Among the analyzed outcomes, arterial hypertension during pregnancy can increase the risk of low weight, small babies for gestational age (SGA), deaths in the neonatal period and enterocolitis, with no differences in weight and survival at 18 months of chronological age. Arterial hypertension presents a high risk of prematurity in the neonatal period, with no difference at 18 months of age.

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Section: Discussionmentioning

confidence: 85%

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Moura¹,

Margotto²,

Costa

et al. 2021

PLoS ONE

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“…In spite of the great number of current advances in the treatment of necrotizing enterocolitis and in neonatology in general, the disease still stands out due to the high morbidity and mortality among premature infants, being one of the main ones in this specific population. Thus, it is necessary at first to look for the main risk factors that contribute to the development of pathology [1,[21][22][23].…”

Section: Risk Factors For Necrotizing Enterocolitismentioning

confidence: 99%

Necrotizing Enterocolitis: Case Report with Bibliographic Review

Morcerf¹,

Cambraia²,

Abbud³

et al. 2018

Pediatric Infect Dis

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Necrotizing enterocolitis (NEC) is the clinical and surgical emergency most frequently found in neonatology with a mortality rate of approximately 50% in newborns weighing less than 1,500 grams. Corresponds to a variety degrees of ischemic necrosis of the newborn's large and small intestines. It has a poorly defined, complex and multifactorial etiology, and it's most commonly found in premature infants. Infectious agents, hypoxia and ischemia have an important role in the etiology of the disease with lesions of the intestinal mucosa triggering inflammatory reaction and necrosis, with enteral nutrition being an extremely relevant factor for the contribution of disease development. The treatment of necrotizing enterocolitis is essentially clinical, but a surgical approach can be performed in some cases of complications, as pneumoperitoneum, fixed intestinal loop on radiological examination and decline in the child's clinical general state. The present paper reports the case of a preterm newborn who developed necrotizing enterocolitis and aims to conduct a discussion associated with dialogues using the current scientific literature regarding the clinical, diagnostic and better management for the case, as well as risk factors and complications.

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“…ECN acomete de maneira especial prematuros de baixo peso, constituindo-se como a mais comum emergência clínica/cirúrgica e a maior causa de morbimortalidade de RN em UTIN no mundo 24. Sua etiologia é desconhecida, mas, possui fatores associados como prematuridade, peso ao nascer, asfixia, sepse, choque, ventilação mecânica, além de evidências que sugerem sua associação com a HG 25. Chama atenção alterações bioquímicas como neutrofilia, elevação do TBARS e hipoglicemia.…”

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Desfechos perinatais em gestantes com síndromes hipertensivas: revisão integrativa

et al. 2020

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Objetivo: identificar na literatura os desfechos perinatais em gestantes com síndromes hipertensivas. Método: trata-se de uma revisão integrativa com coleta de publicações indexadas na LILACS¸ PUBMED, SCOPUS e WEB OF SCIENCE, durante janeiro de 2017. Os descritores utilizados foram: hipertensão induzida pela gravidez, assistência perinatal e neonatologia. Resultados: os desfechos perinatais de maior incidência foram: mortalidade perinatal, prematuridade, baixo APGAR no 1º e 5º minuto de vida, recém-nascidos pequenos para idade gestacional, admissão na unidade intensiva, restrição de crescimento intraútero e parto cesariano. Dentre as patologias investigadas, destacou-se a pré-eclampsia (80,6%) e 3% dos artigos abordaram a pré-eclampsia grave. Conclusões: a realização de investigações que analisem a exposição do feto/neonato à condição materna da pré-eclampsia grave e da hipertensão crônica sobreposta por pré-eclampsia, constitui-se como gaps de conhecimento.

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Avaliação dos fatores perinatais que interferem na incidência de enterocolite necrosante em recém-nascidos de muito baixo peso

Abstract: The only factor that can interfere with the incidence of NEC in infants of very low birth weight was the presence of PE. Awareness of this fact can guide the perinatal team in providing more judicious care regarding the prevention of NEC in this specific population.

Cited by 7 publications

References 22 publications

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Necrotizing Enterocolitis: Case Report with Bibliographic Review

Desfechos perinatais em gestantes com síndromes hipertensivas: revisão integrativa

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