[Health care and mortality of very-low-birth-weight neonates].
OBJECTIVE
To assess inpatient mortality rate of very-low-birth-weight neonates, their clinical progression and factors associated with mortality.


METHODS
Longitudinal study including 360 neonates weighing 500-1500 g who were born in Londrina, Southern Brazil, from January 1, 2002 to June 30, 2004. Data were collected through interviews with the mothers and from medical records and follow-up of neonates during hospitalization. Chi-square test was used to determine the association between variables. Statistically significant variables were selected to the logistic regression model and the level of significance adopted was 5%.


RESULTS
Mortality rate was 32.5%. In bivariate analysis, the following variables were associated with death: no prenatal use of corticosteroids; no hypertension/preeclampsia; labor; vaginal delivery; non-cephalic presentation; Apgar scores <or= 3 at the first and fifth minutes; Clinical Risk Index for Babies score > 5; male sex; weight < or=750 g; gestational age < 28 weeks; resuscitation procedures in the delivery room; respiratory distress syndrome; pneumothorax; intracranial hemorrhage; and mechanical ventilation. In the logistic regression, the following variables were still considered risk factors: low income; no prenatal use of corticosteroids; no use of continuous positive airway pressure.


CONCLUSIONS
Despite technology advances, very-low-birth-weight neonates mortality is high in Brazil compared with developed countries. Prenatal use of corticosteroids should be encouraged to reduce morbidity and mortality of very-low-birth-weight neonates.
Ribeiro de Carvalho
Ana Berenice
AB
Departamento de Pediatria e Cirurgia Pediátrica, Hospital Universitário, Universidade Estadual de Londrina, Londrina, PR, Brasil. anabrcarvalho@uel.br
Jamusse de Brito
Angela Sara
AS
Matsuo
Tiemi
T
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001938:Brazil / Q000453:epidemiology; D019049:Developed Countries; D004812:Epidemiologic Methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008430:Maternal-Child Health Centers; D011181:Postnatal Care; D011295:Prenatal Care
D000305:Adrenal Cortex Hormones