Neonatal death in public maternity of reference: associated factors / Óbito neonatal em maternidade pública de referência: fatores associados

Abstract

Objetivo: investigar os fatores maternos e neonatais associados aos óbitos neonatais em maternidade de referência no sudoeste maranhense. Metodologia: estudo retrospectivo observacional, quantitativo, com análise documental em prontuários. Brasil. Selecionaram-se prontuários de 677 neonatos nascidos no próprio estabelecimento hospitalar no ano de 2016. Resultados: dos 677 prontuários de recém-nascidos admitidos, ocorreram 14,2% de óbitos e 85,8% de altas, a prematuridade foi o diagnóstico entre 42,4%, seguido de 41,9% de distúrbios respiratórios. A análise ajustada do modelo apontou que o óbito neonatal esteve associado a estatura <35cm (OR: 38,40; p<0,001) e de 35- 39cm (OR: 6,65, p<0,002), perímetro cefálico <22 cm (OR: 38,58; p<0,002) e Apgar no 5º. minuto <3 (OR: 5,91; p<0,001). Conclusão: a prematuridade e os distúrbios respiratórios foram as principais causas de internação. Há necessidade de rever o acesso aos serviços de saúde, assim como a implementação de intervenções qualificadas no pré-natal, parto e nascimento.

Construction and validity of educational technology in audiovisual media on premature newborn care

“…As we look forward to all the advances in technology, we find that PNB care remains a constant challenge to reduce the neonatal morbidity and mortality rate worldwide ( 30 ) . The construction and availability of educational technology contributed to the health education process ( 31 ) , since it optimizes the routine of nursing and health professionals, favoring parents, family members and caregivers to reduce doubts and insecurity in premature infant care ( 5 , 30 ) .…”

“…The elaboration of quality educational technologies, based on scientific evidence, makes it possible to carry out educational practices anchored in structured knowledge and directed to the target audience ( 32 ) . As in this study, others also appropriated national and international scientific evidence to elaborate the educational material content which they proposed to carry out ( 5 , 32 , 33 , 34 ) .…”

“…This is methodological research carried out from May to December 2020, in the municipality of Teresina, Piauí. Data collection for storyboard content validity was carried out online, that allowed building and validating a technological strategy that can be implemented both in educational and care environments ( 5 , 9 , 12 ) . The storyboard construction followed the 12 principles (coherence, signaling, redundancy, spatial contiguity, temporal contiguity, segmentation, pre-training, modality, multimedia, personalization, voice and image) of the Cognitive Theory of Multimedia Learning (CTML) ( 16 ) theoretical framework as well as the 3 stages (pre-production, production and post-production) of Kindem’s and Musburger’s methodological framework ( 17 ) .…”

“…Taking into account that the main cause of hospitalizations in neonatal units is prematurity ( 5 ) , premature newborns (PNB) are at high risk of health complications in the short and long term ( 3 ) . The risk of complications and coordination of care makes the moment of hospital discharge crucial for offering instructions directed at PNB’s needs at home ( 5 ) .…”

“…Taking into account that the main cause of hospitalizations in neonatal units is prematurity ( 5 ) , premature newborns (PNB) are at high risk of health complications in the short and long term ( 3 ) . The risk of complications and coordination of care makes the moment of hospital discharge crucial for offering instructions directed at PNB’s needs at home ( 5 ) . Studies show that the role of parents, family members and/or caregivers at home, lack of preparation for parenthood, lower levels of education, low socioeconomic status, hospitalization and experiencing ambivalent feelings, together with pain and isolation, contribute to a difficult emotional situation regarding the experience of home care ( 4 , 6 ) .…”