ObjectiveTo analyze the process of care provided to premature infants in a neonatal
intensive care unit and the factors associated with their mortality. MethodsCross-sectional retrospective study of premature infants in an intensive care
unit between 2008 and 2010. The characteristics of the mothers and premature
infants were described, and a bivariate analysis was performed on the
following characteristics: the study period and the "death" outcome
(hospital, neonatal and early) using Pearson's chi-square test, Fisher's
exact test or a chi-square test for linear trends. Bivariate and
multivariable logistic regression analyses were performed using a stepwise
backward logistic regression method between the variables with p<0.20 and
the "death" outcome. A p value <0.05 was considered to be significant.
ResultsIn total, 293 preterm infants were studied. Increased access to complementary
tests (transfontanellar ultrasound and Doppler echocardiogram) and
breastfeeding rates were indicators of improving care. Mortality was
concentrated in the neonatal period, especially in the early neonatal
period, and was associated with extreme prematurity, small size for
gestational age and an Apgar score <7 at 5 minutes after birth. The
late-onset sepsis was also associated with a greater chance of neonatal
death, and antenatal corticosteroids were protective against neonatal and
early deaths. ConclusionsAlthough these results are comparable to previous findings regarding
mortality among premature infants in Brazil, the study emphasizes the need
to implement strategies that promote breastfeeding and reduce neonatal
mortality and its early component.