Uso antenatal de corticosteóide e evolução clínica de recém-nascidos pré-termo

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:21:06Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:45:23Z : No. of bitstreams: 1 2-s2.0-16644374418.pdf: 161396 bytes, checksum: 04a0f69ab935ed7c1da144338baff11b (MD5) Made available in DSpace on 2014-05-27T11:21:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-07-01 Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Results: Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time, being related to increased occurrence of neonatal sepsis. Conclusions: The use of corticosteroid was associated with better prenatal care and birth conditions, better preterm evolution but higher risk of infection. Copyright © 2004 by Sociedade Brasileira de Pediatria. Hospital Das Clínicas Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo (USP), Ribeirão Preto, SP Centro de Atenção Integral à Saúde da Mulher Universidade Estadual de Campinas (UNICAMP), Campinas, SP Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS Instituto Fernandes Figueira Fundação Oswaldo Cruz, Rio de Janeiro, RJ Hospital São Paulo Escola Paulista de Medicina Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Berçário Anexo à Maternidade do Hospital Das Clínicas de São Paulo Universidade de São Paulo (USP), São Paulo, SP Hospital São Lucas Pontifícia Universidade do Rio Grande do Sul (PUCRS), Porto Alegre, RS Hospital Das Clínicas Faculdade de Medicina de Botucatu Universidade do Estado de São Paulo (UNESP), Botucatu, SP Departamento de Puericultura e Pediatria Faculdade de Medicina de Ribeirão Preto - USP, Av. Bandeirantes, 3900, CEP 14049-900 - Ribeirao Preto, SP Hospital Das Clínicas Faculdade de Medicina de Botucatu Universidade do Estado de São Paulo (UNESP), Botucatu, SP