Fatores de risco para nascimentos pré-termo em Londrina, Paraná, Brasil

Abstract

IntroduçãoSegundo a Classificação Internacional de Doenças 1 , nascimento pré-termo é o que ocorre com menos de 37 semanas de gestação. Essas crianças têm um risco elevado de adoecer e morrer em razão de seu incompleto desenvolvimento fetal e maior suscetibilidade às infecções, complicadas pela manipulação e grande período de permanência nas unidades neonatais. Muitos evoluem com seqüelas neurológicas, oftalmoló-gicas ou pulmonares 2 .Os nascimentos pré-termo são classificados em dois tipos clínicos: espontâneos e por indicação médica. Os espontâneos são subdivididos em dois tipos: o primeiro denominado trabalho de parto prematuro de causa idiopáti-ca, caracteriza-se por contrações uterinas que progridem com ou sem ruptura das membranas amnióticas e o segundo quando a ruptura das membranas amnióticas antecede o trabalho de parto. O nascimento pré-termo por indicação médica ocorre quando por problemas da mãe ou do feto há contra-indicação da continuidade da gravidez 3,4,5 .O limitado conhecimento da etiologia do trabalho de parto prematuro e da ruptura prematura de membranas juntamente com a não intervenção precoce nos problemas maternos e fetais são apontados como fatores que dificultam a redução da freqüência de nascimentos pré-termo 6 .ARTIGO ARTICLE Silva AMR et al.

Nascimento prematuro e assistência pré-natal: revisão integrativa à luz de Canguilhem Premature birth and prenatal care: integrative review in the light of Canguilhem

“…Preterm birth was associated with prenatal care especially relating the insufficient number of prenatal consultations, [18][19][20] the lack of prenatal attendance 17,20 or inadequate access and quality of the given care. [16][17][18][20][21] Studies conclude that these factors contribute to premature birth, low birth weight and subsequent child mortality.…”

“…[16][17][18][20][21] Studies conclude that these factors contribute to premature birth, low birth weight and subsequent child mortality.…”

“…18 The prevalence of preterm births was also high even in the presence of adequate prenatal care evaluated according to the recommended minimum number of queries, finding out that the rise in coverage without improving the quality of prenatal care does not reduce the prevalence of early birth. [20][21] Even though the quality of prenatal care has not been the central object of the investigated studies, this has been pointed as a primary factor to be considered regarding the prevention of preterm birth -considering that many of the risk factors can be avoided or minimized through a good prenatal care. In this case, it is recommended that in addition to the improvement of the quality of life of the population (income and education) and increased access to services, it is essential to guarantee the performance of a good quality prenatal.…”

“…In this case, it is recommended that in addition to the improvement of the quality of life of the population (income and education) and increased access to services, it is essential to guarantee the performance of a good quality prenatal. [16][17][18][20][21] The inadequate or absent prenatal care can be defined as the no detection and subsequent lack of treatment of adverse conditions during pregnancy. In addition to the number of consultations, the early initiation of prenatal care in the first trimester and the care provided to the binomium mother/son are considered important for the reduction of prematurity.…”

“…Even when texts referred to the appropriate amount of consultations during pregnancy, the authors indicated the need for an improvement in care treatments as a strategy to reduce premature births. 17,[20][21] For the improvement in prenatal care -besides the mother's perception of her own health -is important to analyze the pregnant women in the family and community. Thus, it would be formed a bond with the woman, which would promote the continuous monitoring of pregnancy, according to the same principles of the field hospital.…”