Navegando por Palavras-chave "Preterm"

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    Impacto de um pacote de medidas na prevenção da hipotermia do recém-nascido pré-termo do nascimento à admissão na unidade neonatal
    (Universidade Federal de São Paulo (UNIFESP), 2015-10-29) Vale, Marynéa Silva do [UNIFESP]; Almeida, Maria Fernanda Branco de UNIFESP]; Simões, Vanda Maria Ferreira; http://lattes.cnpq.br/4024829764707677; http://lattes.cnpq.br/7346149704101984; http://lattes.cnpq.br/6592249004736678; Universidade Federal de São Paulo (UNIFESP)
    Introdução: Em recém-nascidos pré-termo (RNPT), assegurar a normotermia nos primeiros minutos de vida é um desafio devido à imaturidade do sistema de regulação térmica e à exposição ao ambiente frio ao nascimento. Objetivo: Avaliar o impacto de um pacote de medidas na prevenção da hipotermia do RNPT desde o nascimento até a admissão na Unidade de Terapia Intensiva Neonatal (UTIN). Método: Coorte prospectiva de RNPT de 23 a 33 semanas de idade gestacional sem malformações congênitas nascidos e internados na UTIN da Universidade Federal do Maranhão em dois períodos: I - pré-intervenção (ago/2010-abr/2012; n=254) e II - pós-implantação (ago/2013-jun-2015; n=268) de um pacote de medidas para reduzir a hipotermia (temperatura axilar inferior a 36,0°C) à admissão na UTIN. A intervenção compreendeu capacitar a equipe médica e de enfermagem na prevenção da hipotermia desde o nascimento segundo as diretrizes modificadas do Programa de Reanimação Neonatal da Sociedade Brasileira de Pediatria, além de utilizar a ferramenta de qualidade PDSA (Plan-Do-Study-Act). Avaliou-se a frequência de hipotermia à admissão na UTIN nos dois períodos e as medidas associadas à sua redução por meio de regressão logística. Resultados: As características demográficas maternas e neonatais foram semelhantes nos dois períodos, exceto a maior frequência de uso de corticoide antenatal, infecção perinatal, RN de muito baixo peso ao nascer (PN), ventilação com pressão positiva ao nascer e transporte em suporte ventilatório com gás frio no período II. Comparando-se o período I ao período II, constatou-se frequência de hipotermia 5 minutos após o nascimento - 62% vs 21% e hipotermia à admissão na UTIN - 75% vs 14% (p<0,001). Especificamente nos meses de jul/2014 até jun/2015, 4% (6/131) dos pacientes apresentaram hipotermia à admissão na UTIN, cinco deles com PN inferior a 650g. As medidas de prevenção associadas de maneira independente à hipotermia foram: temperatura na sala de parto/reanimação >=26,0°C (OR 0,19; IC 95% 0,09-0,41), uso de toucas de plástico e algodão ao nascer (OR 0,31; 0,12-0,80), temperatura da incubadora de transporte >=35°C (OR 0,28; 0,13-0,58) e uso de saco plástico no transporte (OR 039; 0,15-1,04) até a UTIN. Apesar das medidas implementadas, a hipotermia à admissão na UTIN que era de 84% (39/46) nos RNPT com peso ao nascer <1000g no período I, ainda ocorreu em 27% (22/80) deles no período II (p<0,001). Já a hipertermia (temperatura axilar >=37,6°C), ausente no período I, foi detectada em 9% dos pacientes no período II (p<0,001). Conclusão: A implantação sistemática de um pacote de medidas acompanhada através da ferramenta de qualidade PDSA reduziu de maneira significativa a hipotermia à admissão na UTIN em prematuros com idade gestacional inferior a 34 semanas.
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    Movimentos espontâneos do sistema orofacial e movimentos gerais em recém-nascidos pré-termo e a termo
    (Universidade Federal de São Paulo (UNIFESP), 2020-11-05) Morais, Regina Donnamaria [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Prechtl’s qualitative General Movements Assessment is a noninvasive method that evaluates the integrity of the central nervous system by observing spontaneous patterns of general movements. The general movements of a deficient nervous system lose its complexity and variability presenting a repertoire of atypical movements, studied and classified by Prechtl as Poor Repertoire, Cramped-Synchronized, Chaotic and abnormal Fidgety movements. There are some researches that evaluate oral movements in the function of feeding as soon as the baby is born, such as sucking and swallowing, coordinated with breathing. However, we found no study that assesses spontaneous movements of the orofacial system unlinked from the function. Objective: To describe the spontaneous movements of the orofacial system of newborns at birth and between 3 and 5 months of age, in order to build a guiding instrument for studies. Describe the spontaneous movements of the orofacial system in low-risk preterm infants, in order to compare the postures and movements of the orofacial system with children at term. Compare the spontaneous movements of the orofacial system, according to the period of Prechtl’s general movements. Compare spontaneous movements of the orofacial system of full-term and preterm newborns, according to the period of Prechtl’s general movements. Methods: The present study refers to a cross-sectional study of preterm babies, born between the twenty-eighth and thirty-sixth gestational week and full-term babies born between the thirty-seventh and forty-second weeks of pregnancy. Results: Ninety-four newborn babies were included and distributed in four groups, 22 preterm and 19 terms babies in the Writhing movement period and 29 preterm and 24 terms babies in the Fidgety period, according to Precthl’s General Movements Assessment. Through a 3-minute video tapping, postures and spontaneous movements of the orofacial system for open and closed lips; broad tongue and tipped tongue; tongue symmetry and commissures were collected. Subsequently, the data obtained in the groups of preterm infants were compared to the groups of full-term neonates and correlated with Prechtl’s General Movement Assessment. No significant differences were found in the analysis of the results according to the classification at birth (preterm and term) nor according to the classification at birth (preterm and term) and period of movement (Writhing and Fidgety) for none of the variables of mouth movement (open or closed), tipped tongue, tongue symmetry and commissure (p>0.05). According to the movement period (Writhing and Fidgety), children in the Fidgety period presented on average higher mean values for open mouth in total number of times (p=0.005), repetition per minute (0.004) and lower mean values in average duration (p=0.010). For closed mouth, higher mean values in total number of times and repetition per minute (p<0.001) and lower mean values in average duration in milliseconds (p=0.017). For tipped tongue values higher in total number of times (p=0.019) and repetition per minute (p=0.033) and tongue symmetry mean values lower in average duration (p=0.032). For symmetry of commissures higher mean values in total number of times and repetition per minute (p<0.001) and lower mean values in average duration in milliseconds (p<0.001) when compared to children in the Writhing period. According to General Movement Assessment by Precthl, at Writhing’s age, among the preterm babies in 90.9% were classified as PR and 9.1% as N, and among term babies, 57.9% were classified as PR and 42.1% as N. At Fidgety’s age, all the preterm and term babies were classified as F+. Conclusions: Both preterms and terms presented movements and postures of the elements of the orofacial system analyzed in both ages. No differences were found in the spontaneous movements of the Orofacial System between term and preterm births, when analyzed as groups, including both ages. Children in the Fidgety period showed greater frequency and intensity for all spontaneous movements of the orofacial system, in relation to the Writhing group. No differences were found in the spontaneous movements of the orofacial system between preterms and terms in each period of Prechtl’s general movement.
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    Prevalência de distúrbios gastrointestinais funcionais em lactentes nascidos prematuros
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-02) Gondim, Marcela Montenegro Braga Barroso [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; http://lattes.cnpq.br/5519219079407797; http://lattes.cnpq.br/5056114729141952; Universidade Federal de São Paulo (UNIFESP)
    Objective: To compare the prevalence of functional gastrointestinal disorders in preterm infants with those of term infants using the Rome IV criteria. Additionally, to evaluate whether invasive procedures during the neonatal period are associated with a higher chance of developing functional gastrointestinal disorders in preterm infants. Methods: Controlled cross-sectional study nested in a retrospective cohort of preterm infants who were compared with term infants for functional gastrointestinal disorders. In the preterm group, infants born with a gestational age <37 weeks were included in the study, and in the term group, infants born with a gestational age > 37 weeks and with a birth weight above 2500 grams were included. A face-to-face medical consultation was performed by a single pediatric gastroenterologist for information on the gestational and neonatal period and information on clinical digestive manifestations. Rome IV criteria were used for diagnosing functional gastrointestinal disorders.Results: We studied 197 infants (<24 months), 99 preterm infants and 98 term infants. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%, p <0.001). The prevalence of other functional gastrointestinal disorders in preterm infants was not different, according to statistical analysis, compared to term infants, respectively: infant colic (10.7% and 4.3%; p= 0.360), functional constipation (17.2% and 9.2%; p= 0.098), functional diarrhea (4.6% and 0.0%; p= 0.274) and infant dyschezia (9.3% and 7.5%; p= 0.735). No relationship was found between invasive procedures performed in the neonatal period and higher risk for developing functional gastrointestinal disorders in preterm infants. Conclusion: In the studied population, preterm infants had no higher prevalence of functional gastrointestinal disorders. No relation was found in preterm infants with invasive diagnostic and therapeutic procedures and the development of gastrointestinal manifestations.
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    Prevalência de doença gengival em adolescentes nascidos pré-termo e a termo
    (Universidade Federal de São Paulo (UNIFESP), 2016-06-20) Spezzia, Sergio [UNIFESP]; Kopelman, Benjamin Israel Kopelman [UNIFESP]; http://lattes.cnpq.br/4138984911182645; http://lattes.cnpq.br/6704918188281863; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate and compare the prevalence of gingival disease in adolescents born preterm and term and if gingival disease is more prevalent in adolescents who were born weighing less than 1500g. Method: It was a cross-sectional study involving adolescents born preterm and term, between 10 and 19 years old. One group consisted of 120 adolescents born preterm and referred to the Neonatology Clinic of the Department of Pediatrics of UNIFESP. The other group consisted of 149 adolescents born at term and referred to clinic of Adolescent Medicine Sector of the Department of Pediatrics of UNIFESP. Measures of pubertal stages were based on physical examinations.The World Health Organization (WHO) community periodontal index of treatment needs (CPITN) was used to assess levels of periodontal condition and treatment needs. The adolescents were classified into three subgroups, according to Tanner stages that were: before the growth spurt, in growth spurt and after the growth spurt. Four outpatient dentists were trained to perform the examination. Results: There were statistically significant differences in the prevalence of gingival disease comparing the two groups. It was found that the term group presented higher prevalence of gingival disease than the preterm group and this difference was statistically significant (p<0.01). There was no statistically significant difference in the prevalence of gingival disease when comparing the groups of preterm adolescents born at less than 1500g and born at 1500g or more. The group of preterm adolescents showed no significant difference in the prevalence of gingival disease compared to Tanner subgroups, but when evaluating the two groups together it was found that the group of girls after the spurt had 3.7 more risk to present gingival disease. Conclusion: The preterm adolescents had lower prevalence of gingival disease (46,7%), than adolescents born at term (76,9%) in this study. This is a special condition because the adolescents in this study are followed from birth in the neonatology clinic for various health professionals, including dentists; it shows that a well done prevention work is able to reduce significantly the risk of gingival disease, but other reason for this result is that the term sample had more girls after growth spurt. The fact that the girls after the growth spurt at a higher risk of developing gum disease, may be related to higher amounts of circulating estrogen at this stage.
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    Transtornos mentais na gravidez e condições do recém-nascido: estudo longitudinal com gestantes assistidas na atenção básica
    (Abrasco, 2018) Costa, Daisy Oliveira [UNIFESP]; Souza, Fabiola Isabel Suano de [UNIFESP]; Pedroso, Glaura Cesar [UNIFESP]; Strufaldi, Maria Wany Louzada [UNIFESP]
    This study aimed to determine the presence and association of possible mental disorders diagnoses in primary care pregnant women and newborns' conditions. This is a longitudinal study with pregnant women (18-39 years), in the second and third trimesters of pregnancy, attended at primary care facilities in the metropolitan region of Sao Paulo (February to August/2014). The following tools were used: sociodemographic questionnaire