title: [Survival and morbidity of premature babies with less than 32 weeks of gestation in the central region of Brazil].
abstract: OBJECTIVE
  To evaluate the survival and complications associated with prematurity of infants with less than 32 weeks of gestation.
  
  
  METHODS
  It was done a prospective cohort study. All preterm infants with a gestational age between 25 and 31 weeks and 6 days, born alive without congenital anomalies and admitted to the NICU between August 1st, 2009 and October 31st, 2010 were included. Newborns were stratified into three groups: G25, 25 to 27 weeks and 6 days; G28, 28 to 29 weeks and 6 days; G30, 30 to 31 weeks and 6 days, and they were followed up to 28 days. Survival at 28 days and complications associated with prematurity were evaluated. Data were analyzed statistically by c² test, analysis of variance, Kruskal-Wallis test, odds ratio with confidence interval (CI) and multiple logistic regression, with significance set at 5%.
  
  
  RESULTS
  The cohort comprised 198 preterm infants (G25=59, G28=43 and G30=96). The risk of death was significantly higher in G25 and G28 compared to G30 (RR=4.14, 95%CI 2.23-7.68 and RR=2.84, 95%CI: 1.41-5.74). Survival was 52.5%, 67.4% and 88.5%, respectively. Survival was greater than 50% in preterm >26 weeks and birth weight >700 g. Neonatal morbidity was inversely proportional to gestational age, except for necrotizing enterocolitis and leukomalacia, which did not differ among groups. Logistic regression showed that pulmonary hemorrhage (OR=3.3, 95%CI 1.4-7.9) and respiratory distress syndrome (OR=2.5, 95%CI 1.1-6.1) were independent risk factors for death. There was a predominance of severe hemorrhagic brain lesions in G25.
  
  
  CONCLUSIONS
  Survival above 50% occurred in infants with a gestational age of more than 26 weeks and >700 g birth weight. Pulmonary hemorrhage and respiratory distress syndrome were independent predictors of neonatal death. It is necessary to identify the best practices to improve the survival of extreme preterm infants.
authors.affiliation: Faculdade de Medicina da Escola Superior de Ciências da Saúde - ESCS - Brasília (DF), Brasil.
authors.forename: Márcia Pimentel
authors.initials: MP
authors.lastname: de Castro
authors.forename: Lígia Maria Suppo Souza
authors.initials: LM
authors.lastname: Rugolo
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Margotto
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate