Predictive factors for the admission of a newborn in an intensive care unit

Abstract

Analytical documentary and retrospective study aiming at determining association between predictive factors for admission of a newborn in a public Intensive Care Unit and maternal features. The study sample had 376 neonates admitted in 2009. Results showed: mothers aged between 19 and 25 years (43.4%), primary education (52.4%), living with a partner (66.2%). Prenatal care was done by 84.8% of them, and 62% presented gestational pathologies. Out of all neonates, 55.1% were male, 85.4% preterm, 83% underweight, 57.2% presented respiratory problems. The bivariate analysis showed a significant association between birth weight and growth (p = 0.04) between maternal age and Apgar in the 1 st minute (p = 0.04) and maternal age and Apgar score in the 5 th minute (p = 0.01). Maternal age and number of prenatal appointments influence on the admission of the neonates to the Intensive Care Unit because they are related to birth weight and Apgar scores.

Epidemiological profile of newborns´ mothers admitted to a public neonatal unit

“…It should be noted that most babies in this study were male, as was observed in studies performed in other neonatal units (8,15) . Regarding the diagnosis/indications of hospitalization of the newborn in the neonatal unit, the results of this study are in line with another research carried out in a Unit of Neonatal Intensive Care of Southern Brazil, which also demonstrated that the main reasons for hospitalization of the newborn preterm infants, low weight and respiratory discomfort (7) .…”

“…Although most women had gestational complications, this fact does not justify the high percentage of cesareans observed in this study (71.9%), as this result is close to other studies also performed in Neonatal Units, which demonstrated a percentage of cesareans around 55 to 60.0% (8,17) . The high rate of prematurity observed in babies born with a cesarean delivery, whose mothers did not present gestational intercurrence, may be linked to the increase of elective cesarean sections, also leading to an increase in prematurity (18) .…”

“…When performed without adequate indication, this surgical procedure can generate serious complications that may lead to the need for intensive treatment of the newborn in a specialized unit. Brazil is experiencing an epidemic of cesarean operations, and in recent years the increase in the rate of cesarean sections has increased progressively, becoming a major public health problem (8,18) .…”

“…Regarding the characteristics of neonates hospitalized in a neonatal unit, prematurity, and low birth weight represents the main reasons for admissions. These newborns, in the great majority, demand special and continuous care, since they are more likely to be infected, delayed in development and died (7)(8) .…”

Respiratory changes related to prematurity in neonatal intensive care

“…The body needs to make physiological adjustments immediately after birth, especially in those born prematurely. In this sense, the preterm newborn should receive specialized care in the delivery room, which consists of maintaining body temperature, establishing a patent airway and stimulating breathing (16) .…”