title: Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in newborns.
abstract: OBJECTIVE
  to determine the prevalence of pulmonary hemorrhage in newborns and evaluate the associated risk factors and outcomes.
  
  
  METHODS
  this was a retrospective case-control study involving 67 newborns who met the criteria for pulmonary hemorrhage. A control was selected for each case: the next-born child of the same gender, similar weight (± 200g) and gestational age (± 1 week), with no previous pulmonary hemorrhage and no malformation diagnosis. Factors previous to pulmonary hemorrhage onset, as well as aspects associated to the condition, were assessed.
  
  
  RESULTS
  the prevalence was 6.7 for 1,000 live births, and the rates observed were: 8% among newborns <1,500g, and 11% among newborns <1,000g. Intubation in the delivery room (OR=7.16), SNAPPE II (OR=2.97), surfactant use (OR=3.7), and blood components used previously to pulmonary hemorrhage onset (OR=5.91) were associated with pulmonary hemorrhage. In the multivariate logistic regression model, only intubation in delivery room and previous use of blood components maintained the association. Children with pulmonary hemorrhage had higher mortality (OR=7.24). Among the survivors, the length of stay (p ≤ 0.01) and mechanical ventilation time were longer (OR=25.6), and oxygen use at 36 weeks of corrected age was higher (OR=7.67).
  
  
  CONCLUSIONS
  pulmonary hemorrhage is more prevalent in premature newborns, and is associated with intubation in the delivery room and previous use of blood components, leading to high mortality and worse clinical evolution.
authors.affiliation: Section of Neonatology of Hospital das Clínicas de Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil. Electronic address: crisfaleiros@usp.br.
authors.forename: Cristina Helena
authors.initials: CH
authors.lastname: Ferreira
authors.affiliation: Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
authors.forename: Fábio
authors.initials: F
authors.lastname: Carmona
authors.affiliation: Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
authors.forename: Francisco Eulógio
authors.initials: FE
authors.lastname: Martinez
mesh_terms: D001034:Apgar Score; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011663:Pulmonary Surfactants / Q000009:adverse effects; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D011663:Pulmonary Surfactants
keywords: Blood components; Hemoderivados; Hemorragia pulmonar; Mortalidade; Mortality; Newborn; Prematuridade; Prematurity; Pulmonary hemorrhage; Recém-nascido