Navegando por Palavras-chave "Asphyxia neonatorum"

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    Early neonatal deaths associated with perinatal asphyxia in infants >= 2500 g in Brazil
    (Soc Brasil Pediatria, 2017) Branco de Almeida, Maria Fernanda [UNIFESP]; Kawakami, Mandira Daripa [UNIFESP]; Oliveira Moreira, Licia Maria; Vaz dos Santos, Rosa Maria; Anchieta, Leni Marcia; Guinsburg, Ruth [UNIFESP]
    Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing >= 2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight >= 2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0). An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing >= 2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38%) of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001); the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight andwithout congenital malformations are still high, and meconium aspiration syndrome plays a major role. (c) 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.
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    Epidemiologia dos óbitos neonatais hospitalares associados à asfixia perinatal em Maceió, Alagoas, 2009
    (Universidade Federal de São Paulo (UNIFESP), 2010-11-24) Oliveira, Junko Asakura Bezerra de [UNIFESP]; Almeida, Maria Fernanda Branco de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Alagoas has the highest infant and neonatal mortality rates among all the States of Brazil and thus it urges to know its determinants. Aim: to describe the epidemiology of neonatal mortality associated with asphyxia in public maternity hospitals, besides the infra-structure of neonatal assistance, in Maceió, capital of Alagoas State, in 2009. Methods: This is a cross-sectional study with daily active search for medical records of mothers and their newborns who died under 28 days of age in 8 public maternity hospitals in Maceió, from Jan/1st until Dec/31st 2009. Death was considered associated with asphyxia if, at least, one criteria was present: Apgar score <6 at 5 minutes; meconium aspiration syndrome (MAS); hypoxic-ischemic encephalopathy; Apgar score <3 in the 1st minute with ventilation at birth; death record of hypoxia/asphyxia at birth. Patients with major malformations, birth weight <400g or gestational age <22 weeks were excluded. Descriptive analysis of patients included the variables of location and condition of birth and death, morbidity and therapeutic interventions. Information on physical structure, material and human resources were collected from hospitals in March and September/09. Results: In 2009, in the eight public maternity hospitals 20860 babies were born and there were 326 neonatal deaths, of which 243 (74%) were preventable. Asphyxia was present in 113 (46%) cases, of which 15 died without intensive care and 24 came from others institutions. Out of 113 deaths, 12 did not receive any resuscitation procedures and nine of them were 22-27 weeks old. Out of 86 low birth weight newborns, 79 (92%) were born with obstetrician and pediatrician care, 75 (87%) developed respiratory distress syndrome, 41 (48%) received surfactant and 41 had neonatal sepsis. Ten (37%) of the group with birth weight >2500g (27 newborns) were born without obstetrician nor pediatrician care and 17 (68%) had meconium aspiration syndrome. Regarding the interventions, 7 did not receive mechanical ventilation, 19 (70%) received aminas and only 2 had monitored blood pressure. Out of 113 deaths, 42% died before 24h and 42% between 2 and 6 days after birth. The death registration referred asphyxia in 37% of the cases and necropsy was performed in 4 cases. In the eight public maternity hospitals, where there were born 1 to 12 newborns, the number of resuscitation tables ranged from 1 to 3. Four public maternities had physical infrastructure, material and equipment for neonatal resuscitation in the delivery room. There were pediatricians all the time in seven maternities; 62% of the pediatricians attended a neonatal resuscitation course in the last two years. Out of the nursing staffs, 49% attended to the course, but one staff had never attended one. The physical infrastructure, material and equipment did not change along the year. Conclusion: In the City of Maceio, in 2009, asphyxia at birth was presented in half of the neonatal death in-hospital. In the majority of the cases there were pediatricians in the delivery room, mainly in the low birth weight cases. There were neonatal deaths in intermediate care units, and it shows the frailty of physical infrastructure and equipments, associated to the severity at birth.