1
|
Barreto MGP, Manso MC, Barreto RP, Barreto RP, de Vasconcelos LMT, Silva C. Frequency and Risk Factors Associated with Prematurity: A Cohort Study in a Neonatal Intensive Care Unit. J Clin Med 2024; 13:4437. [PMID: 39124704 PMCID: PMC11313331 DOI: 10.3390/jcm13154437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/23/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: Prematurity rates remain high and represent a challenge for the public health systems of any country, with a high impact on neonatal mortality. This study aimed to evaluate the frequency and environmental and maternal-fetal risk factors for premature birth in a cohort of parturient women, with their newborns monitored in a neonatal intensive care unit at a private reference hospital. Methods: A cohort was carried out between 2013 and 2018 among parturient women living in a capital city in the Northeast of Brazil whose newborns were admitted to the neonatal intensive care unit. This study was approved by the Research Ethics Committee of the University of Fortaleza. The information collected comprised data from both medical records and hydrosanitary data from maternal homes. Results: The prevalence of prematurity among live births (n = 9778) between 2013 and 2018 at this hospital was 23%. The frequency of prematurity among those eligible (n = 480) was 76.9%, and the frequency of eligible premature babies (n = 369) in relation to the total number of births in this period was 3.8%. In the multivariate analysis, the significant risk factors for prematurity were primigravida (RR = 1.104, 95%CI: 1.004-1.213) and hypertensive syndromes during pregnancy (RR = 1.262, 95%CI: 1.161-1.371), and the significant protective factor was the highest number of prenatal consultations (RR = 0.924, 95%CI: 0.901-0.947). Conclusions: This study contributes to providing greater visibility to prenatal care and the understanding of complications during pregnancy and childbirth care. These results indicate the need to implement public policies that promote improvements in the population's living conditions and care for pregnant women to reduce premature births and, consequently, neonatal and infant mortality.
Collapse
Affiliation(s)
- Maria Goretti Policarpo Barreto
- Faculdade de Ciências e Tecnologias, Universidade Fernando Pessoa, Praça 9 de Abril 349, 4249-004 Porto, Portugal
- Hospital Regional Unimed Fortaleza (HRU), Avenida Visconde do Rio Branco, 400, São João do Tauape, Fortaleza 60420-570, Brazil; (R.P.B.); (R.P.B.); (L.M.T.d.V.)
| | - Maria Conceição Manso
- Faculdade de Ciências da Saúde, RISE-Health, Universidade Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150 Porto, Portugal;
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, Praça de 9 de Abril 349, 4249-004 Porto, Portugal
- REQUIMTE-LAQV (Laboratório Associado de Química Verde), Universidade do Porto, 4050-313 Porto, Portugal
| | - Renata Policarpo Barreto
- Hospital Regional Unimed Fortaleza (HRU), Avenida Visconde do Rio Branco, 400, São João do Tauape, Fortaleza 60420-570, Brazil; (R.P.B.); (R.P.B.); (L.M.T.d.V.)
- Centro de Ciências da Saúde, Universidade de Fortaleza (UNIFOR), Avenida Washington Soares, 1321, Edson Queiroz, Fortaleza 60811-905, Brazil
| | - Roberta Policarpo Barreto
- Hospital Regional Unimed Fortaleza (HRU), Avenida Visconde do Rio Branco, 400, São João do Tauape, Fortaleza 60420-570, Brazil; (R.P.B.); (R.P.B.); (L.M.T.d.V.)
- Centro de Ciências da Saúde, Universidade Federal do Ceará (UFC), Avenida da Universidade, 2853, Benfica, Fortaleza 60020-181, Brazil
| | - Lara Moreira Teles de Vasconcelos
- Hospital Regional Unimed Fortaleza (HRU), Avenida Visconde do Rio Branco, 400, São João do Tauape, Fortaleza 60420-570, Brazil; (R.P.B.); (R.P.B.); (L.M.T.d.V.)
- Centro de Ciências da Saúde, Universidade de Fortaleza (UNIFOR), Avenida Washington Soares, 1321, Edson Queiroz, Fortaleza 60811-905, Brazil
| | - Cláudia Silva
- Faculdade de Ciências da Saúde, RISE-Health, Universidade Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150 Porto, Portugal;
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, Praça de 9 de Abril 349, 4249-004 Porto, Portugal
| |
Collapse
|
2
|
Nascimento MVF, Alvarenga WDA, Gouveia MTDO, Jorge HMF, de Carvalho MRD, Amaral JV, da Rocha SS. Construction and validity of educational technology in audiovisual media on premature newborn care. Rev Bras Enferm 2023; 76Suppl 4:e20220403. [PMID: 37970980 PMCID: PMC10637280 DOI: 10.1590/0034-7167-2022-0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/07/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES to construct and validate an educational video storyboard about care for premature newborns at home. METHODS a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index. RESULTS the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard's final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9. CONCLUSIONS the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.
Collapse
Affiliation(s)
- Marcelo Victor Freitas Nascimento
- Universidade Federal do Piauí. Teresina, Piauí, Brazil
- Empresa Brazileira de Serviços Hospitalares. Brasília, Distrito Federal, Brazil
| | | | | | | | | | | | | |
Collapse
|
3
|
Teixeira CS, Fernandes TG, Dias MAB, Morais das Neves MDS, Schweickardt JC, Harris MJ, de Sousa Lima RT. Perinatal Health in Amazon Triple Border Region: Cross-Sectional Analysis Comparing Outcomes in the Brazilian, Peruvian and Colombian Population. Matern Child Health J 2023; 27:1876-1884. [PMID: 37278842 DOI: 10.1007/s10995-023-03673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the perinatal outcomes in Brazilian, Peruvian, and Colombian women in a Brazilian reference maternity hospital based at Amazon triple border region. METHOD A cross-sectional case study of data from 3242 live birth certificates issued at the Tabatinga public maternity hospital, in the countryside of Amazonas, in the period between January 2015 and December 2017. Maternal and perinatal independent variables were analysed based on central tendency and variability, and frequency distribution for categorical variables. The Pearson's Chi-Square test and univariate analyses were performed to estimate probability ratios (Odds Ratio-OR). RESULTS Significant differences were found in the education level in the three population groups, as well as in the number of previous pregnancies, antenatal consultations, month of initial prenatal care, and type of delivery. Brazilian pregnant women had more prenatal consultations, caesarean sections, and premature births. Peruvian and Colombian women started antenatal care later, and those with high-risk pregnancies tended to deliver in their home country. CONCLUSION FOR PRACTICE Our findings show some singularities in the care of women and infants in the Amazonian triple border region. The Brazilian Unified Health Care System performs an important role in the guarantee of free access to health services, and ensures comprehensive care for women and infants, promoting human rights in border regions regardless of nationality.
Collapse
Affiliation(s)
- Camila Soares Teixeira
- Leonidas e Maria Deane Institute, Oswaldo Cruz Foundation - FIOCRUZ, Manaus, Amazonas, Brasil.
| | - Tiótrefis Gomes Fernandes
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas - UFAM, Manaus, Brazil
| | | | | | | | - Matthew J Harris
- The School of Public Health, Imperial College London, London, UK
| | | |
Collapse
|
4
|
Amthauer C, Cunha MLCD. Maternal and neonatal factors associated with hospital readmission of newborns of adolescent mothers. Rev Gaucha Enferm 2023; 44:e20220063. [PMID: 37222389 DOI: 10.1590/1983-1447.2023.20220063.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/26/2022] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To analyze the maternal and neonatal factors in newborns of adolescent mothers associated with hospital readmission in the neonatal period. METHOD Quantitative cross-sectional, retrospective and analytical study, with 489 newborns of adolescent mothers, born in 2019 and 2020 in a high-complexity public hospital in southern Brazil. Data were collected through a query and analyzed in the SPSS software using the chi-square or Fisher's exact tests. To control for confounding factors, the multivariate Poisson regression model was used. RESULTS The prevalence of hospital readmissions for newborns of adolescent mothers was 9.2%, mainly due to respiratory conditions, being the most prevalent the diagnosis of acute bronchiolitis, at 22.3%. CONCLUSION Neonatal hospital readmission was associated with prematurity, 1st minute Apgar <7 and maternal origin.
Collapse
Affiliation(s)
- Camila Amthauer
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Maria Luzia Chollopetz da Cunha
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil. Porto Alegre, Rio Grande do Sul, Brasil
| |
Collapse
|
5
|
Khasawneh W, Alyousef R, Akawi Z, Al-Dhoon A, Odat A. Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis. Front Pediatr 2021; 9:685016. [PMID: 34222151 PMCID: PMC8242188 DOI: 10.3389/fped.2021.685016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although late preterm infants (LPIs) account for the majority of preterm births, they are mistakenly labelled and treated as "near term." Whether longer initial hospital stay improves their outcomes and lowers readmission is controversial. The aim of this study is to identify maternal and perinatal factors associated with longer hospital stay and to assess the rate of readmission. Methods: The medical records of LPIs delivered at an academic center in Jordan over a 5-year period were reviewed. They were divided according to their initial hospital stay into: Early discharge group (ED, ≤ 3 days) and late discharge group (LD, > 3 days). Maternal and perinatal factors associated with > 3-day hospital stay were reported. The rate of readmission was compared between both groups. Results: 2236 LPIs were included in the analysis representing 13% of total births and 81% of premature births. LD group constituted 54%. A thousand two hundred forty three (56%) required admission to NICU. Factors associated with longer hospital stay included maternal prolonged rupture of membranes (AOR 1.9, 95% C.I 1.5, 2.4, p 0.000), C-section delivery (AOR 2.4, 95% C.I 1.9, 3, p 0.001), <35-week gestation (AOR 3.8, 95% C.I 2.6, 5, p 0.000), small-for-gestational age (AOR 1.9, 95% C.I 1.1, 3.8, p 0.03), birthweight <2,500 g (AOR 1.3, 95% C.I 1.1, 1.6, p 0.02), NICU admission (AOR 6.3, 95% C.I 3.4, 11.5, p 0.000), RDS (AOR 2.3, 95% C.I 1.5, 3.6, p 0.005), surfactant therapy (AOR 5, 95% C.I 1.9, 13.5, p 0.001), use of CPAP (AOR 1.7, 95% C.I 1.2, 2.2, p 0.001), jaundice (AOR 11.2, 95% C.I 7.7, 16.2, p 0.000), and sepsis (AOR 10.3, 95% C.I 4.8, 22, p 0.000). Readmission rate was 19% among the LD group and 13% among the ED group. Conclusion: LPIs are at high risk for developing prematurity-related morbidities and the duration of their initial hospital stay can be anticipated based on certain predisposing maternal and perinatal factors. Late discharge of LPIs does not lower the rate of readmission.
Collapse
Affiliation(s)
- Wasim Khasawneh
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rahaf Alyousef
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Zuhour Akawi
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Areen Al-Dhoon
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahlam Odat
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
6
|
Torres-Muñoz J, Jiménez-Fernandez CA, Ortega RR, Cuero DJM, Mendoza DM. Factors Associated With Late Prematurity in the University Hospital of Valle Cali, Colombia During 2013-2014. Front Public Health 2020; 8:200. [PMID: 32754564 PMCID: PMC7366421 DOI: 10.3389/fpubh.2020.00200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: The birth rate of late premature babies has been increasing in recent years, composing now 75% of all premature births. This growing trend can be explained by different demographic transformations such as an increase in the demand for infertility treatments, older maternal age and the higher incidence of multiple pregnancies, cesarean sections, and labor induction. These premature babies contribute 30% to the global neonatal mortality rate. Objective: To identify the factors associated with late prematurity at the Hospital Universitario del Valle during the years 2013-2014. Methodology: Case and control design, 424 patients, 212 cases and 212 controls participated. Cases were defined as newborns with gestational age between 34 and 36 weeks and 6 days old. For the analysis, logistic regression models were developed and association forces (OR) were determined. Results: A univariate analysis shows that the proportion of teenage pregnant women corresponds to 22.64%. Bivariate analysis shows the maternal morbidity due to hypertensive disorders was 1.6 times higher (95% CI 1.06-2.63), the obstetric alterations in 2.9 times (CI of 95% 1.56-5.44), late preterm infants require more oxygen support 3.26 times (95% CI 1.76-6.03). After adjusting the model, it was found that late premature infants have a 3-fold probability of requiring some resuscitation maneuver (ORa 3.23 95% CI 2.09-4.99), birth is higher by cesarean section by 4.17 times (ORa 4.17 IC 95% 2.50-6.98), maternal morbidity was higher in 1.37 times (ORa 1.37 95% CI 1.14-1.65). The morbidity of the newborn was greater, close to the statistical significance for late premature infants in 1.26 times (ORa 1.26 95% CI 0.97-1.64). Conclusions: Late premature births in this study show a higher probability of developing morbidity, have a greater opportunity to be born by cesarean section, are products of mothers with morbidity (specifically hypertensive disorders), and require further resuscitation with a need of early obstetric intervention.
Collapse
Affiliation(s)
- Javier Torres-Muñoz
- INSIDE Research Group Department of Pediatrics Universidad del Valle, University Hospital of Valle, Cali, Colombia
| | | | - Rubi Rocio Ortega
- Department of Pediatrics, University Hospital of Valle, Cali, Colombia
| | | | - Diana Marcela Mendoza
- Faculty of Health, Medicine and Surgery Program, School of Medicine, Universidad del Valle, Cali, Colombia
| |
Collapse
|