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Factores de risco para a prematuridade extrema e moderada : caracterização e análise de uma amostra de RN com menos de 33 semanas de gestação internados na Unidade de Cuidados Intensivos Neonatais do HSM
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Resumo(s)
Apesar da progressão do conhecimento das causas que levam ao parto pré-termo (PPT), num considerável número de casos alguns aspectos permanecem desconhecidos.
Pretende-se contribuir para uma melhor compreensão destas ocorrências caracterizando e analisando uma amostra de prematuros com idade gestacional (IG) no parto inferior a 33 semanas, internados na Unidade de Cuidados Intensivos Neonatais (UCIN) do Centro Hospitalar Lisboa Norte - Hospital de Santa Maria (CHLN, HSM), em Lisboa. Foram recolhidas para este estudo variáveis relacionadas com o recém-nascido (RN), a gravidez, a mãe, o agregado familiar, o pai e a história familiar numa amostra de 51 puérperas e, respectivamente, 65 recém-nascidos. O método de recolha envolveu a identificação de RN com IG no parto <33 semanas internados na UCIN, a aplicação de um inquérito por questionário e consulta do processo dos RN e das respectivas mães internadas no puerpério. Recolhidos os dados, procedeu-se à sua análise descritiva e exploratória incluindo frequências simples e condicionais. A análise exploratória incluiu ainda boxplots.
Os principais resultados obtidos apontam para uma predominância na amostra de mães com idade entre 18-34 anos (52,9%), com história de internamento durante a gravidez (60,8%) e que tiveram como principal motivo de internamento no bloco de partos a indução do trabalho de parto (45,1%). Quanto aos RNs, salientamos o facto de não haver diferença significativa entre sexos (55,4% do sexo feminino), identificação de três óbitos e dois diagnósticos de malformações congénitas.
Conclui-se que, dada a amostra recolhida, certos factores de risco para a prematuridade descritos pela literatura não se mostraram mais prevalentes na amostra, verificando-se em alguns casos o contrário. No entanto, constituem importantes limitações do estudo a reduzida dimensão da amostra bem como o carácter descritivo numa população específica sem grupo de controlo. Considera-se que o presente trabalho pode constituir um ponto de partida para um estudo de caso-controlo de maiores dimensões para a avaliação dos factores de risco para PPT em Portugal.
Despite advances in knowledge of the causes that lead to preterm delivery (PTD), in a considerable number of cases there are still some unknown aspects. The objective is to contribute to a better understanding of these events characterizing and analyzing a sample of preterm infants with gestational age (GA) of pregnancies less than 33 weeks admitted to the Neonatal Intensive Care Unit (NICU) of the Northern Section of Lisbon Hospital Center - Hospital de Santa Maria. Data collection focused on variables related to the newborn (NB), pregnancy, mother, household, father and family history, comprising 51 mothers and the respectively 65 newborns. The collection method involved the identification of newborns with GA at birth <33 weeks admitted to the NICU and the application of a questionnaire and consultation process of newborns and their mothers admitted postpartum. Having collected the data, we proceeded to undertake a descriptive and explanatory analysis including simple and conditional frequencies. The explanatory analysis also included boxplots. The main results point to a predominance, in the sample, of mothers of childbearing age between 18-34 (52.9%) with history of hospitalization during pregnancy (60.8%). The main reason for hospitalization was the induction of labour (45.1%). As for NBs, we stress the fact that there were no significant differences between gender (55.4% were female), the occurrence of three deaths and two diagnoses of congenital malformations. It is concluded that, given the sample collected, that certain risk factors for prematurity described in the literature were not more prevalent in the sample, with some cases with opposite results. However, the small sample size of the sample should be stressed as well as the fact that this is a descriptive study of a sample of a specific population without no control group. The current work should be considered a starting point for a study of greater dimension to evaluate the risk factors with the PPT in Portugal.
Despite advances in knowledge of the causes that lead to preterm delivery (PTD), in a considerable number of cases there are still some unknown aspects. The objective is to contribute to a better understanding of these events characterizing and analyzing a sample of preterm infants with gestational age (GA) of pregnancies less than 33 weeks admitted to the Neonatal Intensive Care Unit (NICU) of the Northern Section of Lisbon Hospital Center - Hospital de Santa Maria. Data collection focused on variables related to the newborn (NB), pregnancy, mother, household, father and family history, comprising 51 mothers and the respectively 65 newborns. The collection method involved the identification of newborns with GA at birth <33 weeks admitted to the NICU and the application of a questionnaire and consultation process of newborns and their mothers admitted postpartum. Having collected the data, we proceeded to undertake a descriptive and explanatory analysis including simple and conditional frequencies. The explanatory analysis also included boxplots. The main results point to a predominance, in the sample, of mothers of childbearing age between 18-34 (52.9%) with history of hospitalization during pregnancy (60.8%). The main reason for hospitalization was the induction of labour (45.1%). As for NBs, we stress the fact that there were no significant differences between gender (55.4% were female), the occurrence of three deaths and two diagnoses of congenital malformations. It is concluded that, given the sample collected, that certain risk factors for prematurity described in the literature were not more prevalent in the sample, with some cases with opposite results. However, the small sample size of the sample should be stressed as well as the fact that this is a descriptive study of a sample of a specific population without no control group. The current work should be considered a starting point for a study of greater dimension to evaluate the risk factors with the PPT in Portugal.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Prematuridade Prematuros Parto pré-termo Factores de risco Idade gestacional Unidade de cuidados intensivos neonatais