Providers' compliance with practice guidelines of prenatal and neonatal care to reduce neonatal mortality: 2004 versus 2012.
To evaluate providers' compliance with practice guidelines of prenatal and neonatal care in order to reduce neonatal mortality.
Uncontrolled before-and-after study designed to evaluate changes that occurred between 2004 and 2012, after the interventions proposed by the Municipality Committee of Research on Child Deaths, Foetal and Maternal Death (COMAI) on the frequency of the process indicators for perinatal assistance improvement. A total of 254 patients were studied in 2004 and 259 patients in 2012.
During the study period, there was an increase of 65% in the use of prenatal corticosteroids among pregnant women in preterm labor with gestational age of ≤ 34 weeks (rate of use of 38.0 and 62.8% in 2004 and 2012, respectively; p < 0.001), 35% of increase in the use of surfactant among newborns with ≤ 34 weeks of gestational age (41.3 and 55.6% in 2004 and 2012, respectively; p = 0.025) and a reduction of 16% in the prevalence of hypothermia (70.8 and 59.4% in 2004 and 2012, respectively; p = 0.009) at the neonatal intensive care unit admission.
Prenatal and neonatal care practices improved between 2004 and 2012. At the end of the study period, rates of use of antenatal steroids and surfactant were lower than figures reported internationally. Similarly, the frequency of hypothermia at the neonatal intensive care unit admission was higher than the occurrence observed in developed countries.
Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas - Pelotas (RS), Brasil.
Renata Jaccottet
RJ
Freitas
Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas - Pelotas (RS), Brasil.
Tiago Neuenfeld
TN
Munhoz
Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas - Pelotas (RS), Brasil.
Iná da Silva Dos
ID
Santos
Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas - Pelotas (RS), Brasil.
Flávio Sérgio
FS
Chiuchetta
Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas - Pelotas (RS), Brasil.
Fernando
F
Barros
Faculdade de Medicina, Universidade Católica de Pelotas - Pelotas (RS), Brasil.
Aline
A
Coletto
Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas - Pelotas (RS), Brasil.|Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil.
Alicia
A
Matijasevich
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D065187:Controlled Before-After Studies; D005260:Female; D005865:Gestational Age; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards
D000305:Adrenal Cortex Hormones