Resultados perinatais de neonatos com gastrosquise em uma maternidade de referência do Ceará: estudo retrospectivo
Data
2024-10-14
Autores
Esteche, Cinthia Maria Gomes da Costa Escoto 
Orientadores
Paiato, Liliam Cristine Rolo
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Avaliar os desfechos de recém-nascidos(RN) com gastrosquise em uma maternidade terciária em Fortaleza- Ceará; apresentar a prevalência da gastrosquise entre 2014-2022. Método: Estudo observacional, retrospectivo, coorte de base hospitalar, realizado em RN com gastrosquise na Maternidade Escola Assis Chateaubriand (MEAC), Universidade Federal do Ceará/ EBSERH, entre 2014 e 2022. Foram analisados os prontuários de todos os RN portadores de gastrosquise e que nasceram na maternidade referida, perfazendo uma amostra total de 46 RN. Os dados do estudo foram coletados e gerenciados usando a ferramenta REDCap. As variáveis foram apresentadas em média e desvio-padrão e mediana, percentis, razão de chance. Na investigação de associação entre as variáveis foram utilizados os seguintes testes: Teste qui-quadrado de independência; Teste de soma de postos de Wilcoxon; Teste exato de Fisher e regressão logística binominal. Adotou-se um nível de significância de 5%. As análises estatísticas foram realizadas utilizando o programa estatístico R. Resultados: Nos casos de gastrosquise analisados, observou-se que 65,2% dos recém-nascidos tiveram alta, enquanto 34,8% vieram a óbito. Dos 46 casos identificados, 44 foram categorizados, sendo 33 como gastrosquise simples e 11 como gastrosquise complexa. Em 97,8% dos recém-nascidos foi realizada alguma intervenção cirúrgica, sendo que em 71,1% dos casos foi feita apenas uma intervenção e 82,2% dos recém-nascidos receberam reparo por fechamento primário. A infecção neonatal foi a intercorrência clínica mais frequente. Todos os recém-nascidos foram encaminhados para a UTIN. Conclusão: A mortalidade em recém-nascidos com gastrosquise é multifatorial e influenciada por diversos fatores relacionados à mãe, ao bebê e à assistência recebida. A otimização do acompanhamento pré-natal, a realização de um fechamento primário precoce e a minimização do tempo de ventilação mecânica são medidas importantes para melhorar o prognóstico desses bebês.
Objectives: To evaluate the outcomes of newborns (NB) with gastroschisis in a tertiary maternity hospital in Fortaleza, Ceará; to present the prevalence of gastroschisis between 2014-2022. Method: This was an observational, retrospective, hospital-based cohort study of NBs with gastroschisis at the Assis Chateaubriand Maternity School (MEAC), Federal University of Ceará/ EBSERH, between 2014 and 2022. The medical records of all NBs with gastroschisis who were born in the maternity hospital were analyzed, making up a total sample of 46 NBs. The study data was collected and managed using the REDCap tool. The variables were presented as means and standard deviations and medians, percentiles and odds ratios. The following tests were used to investigate the association between the variables: chi-square test of independence; Wilcoxon rank sum test; Fisher's exact test and binominal logistic regression. A significance level of 5% was adopted. Statistical analyses were carried out using the statistical program R. Results: In the gastroschisis cases analyzed, it was observed that 65.2% of the newborns were discharged, while 34.8% died. Of the 46 cases identified, 44 were categorized, 33 as simple gastroschisis and 11 as complex gastroschisis. Some form of surgical intervention was performed on 97.8% of the newborns, with only one intervention being performed in 71.1% of the cases and 82.2% of the newborns receiving primary closure repair. Neonatal infection was the most common clinical complication. All the newborns were referred to the NICU. Conclusion: Mortality in newborns with gastroschisis is multifactorial and influenced by various factors related to the mother, the baby and the care received. Optimizing prenatal care, performing an early primary closure and minimizing the time spent on mechanical ventilation are important measures to improve the prognosis of these babies.
Objectives: To evaluate the outcomes of newborns (NB) with gastroschisis in a tertiary maternity hospital in Fortaleza, Ceará; to present the prevalence of gastroschisis between 2014-2022. Method: This was an observational, retrospective, hospital-based cohort study of NBs with gastroschisis at the Assis Chateaubriand Maternity School (MEAC), Federal University of Ceará/ EBSERH, between 2014 and 2022. The medical records of all NBs with gastroschisis who were born in the maternity hospital were analyzed, making up a total sample of 46 NBs. The study data was collected and managed using the REDCap tool. The variables were presented as means and standard deviations and medians, percentiles and odds ratios. The following tests were used to investigate the association between the variables: chi-square test of independence; Wilcoxon rank sum test; Fisher's exact test and binominal logistic regression. A significance level of 5% was adopted. Statistical analyses were carried out using the statistical program R. Results: In the gastroschisis cases analyzed, it was observed that 65.2% of the newborns were discharged, while 34.8% died. Of the 46 cases identified, 44 were categorized, 33 as simple gastroschisis and 11 as complex gastroschisis. Some form of surgical intervention was performed on 97.8% of the newborns, with only one intervention being performed in 71.1% of the cases and 82.2% of the newborns receiving primary closure repair. Neonatal infection was the most common clinical complication. All the newborns were referred to the NICU. Conclusion: Mortality in newborns with gastroschisis is multifactorial and influenced by various factors related to the mother, the baby and the care received. Optimizing prenatal care, performing an early primary closure and minimizing the time spent on mechanical ventilation are important measures to improve the prognosis of these babies.
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Citação
ESTECHE, Cinthia Maria Gomes da Costa Escoto. Resultados perinatais de neonatos om gastrosquise em uma maternidade de referência do Ceará: estudo retrospectivo. 2024. 100 f. Tese (Doutorado em Obstetrícia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.