Prematuridad extrema en una unidad pública de referencia: morbilidad, viabilidad y mortalidad
DOI:
https://doi.org/10.33448/rsd-v11i6.29468Palabras clave:
Recien nacido prematuro; Morbilidad; Mortalidad; Viabilidad fetal.Resumen
El nacimiento prematuro es un problema de salud pública, debido a la elevada mortalidad y al riesgo de discapacidades graves a lo largo de la vida. El objetivo fue evaluar la morbilidad y la mortalidad en una maternidad de alto riesgo y conocer el umbral de viabilidad. La muestra se seleccionó en cuatro etapas: identificación, selección, estratificación de los recién nacidos prematuros por edad gestacional y peso al nacer, y cumplimentación de un formulario estructurado. Se evaluaron los neonatos de hasta 31 semanas que tuvieron un resultado de muerte, en el período entre agosto de 2015 y agosto de 2020, mediante una encuesta retrospectiva, basada en el análisis descriptivo de las variables relacionadas con la gestación, el parto y el recién nacido. Se describieron los porcentajes absolutos y relativos para las variables categóricas y el cálculo de la media, la mediana y la desviación estándar, el valor mínimo y el máximo para las variables cuantitativas continuas. La mayoría de los recién nacidos tenían una edad gestacional baja (56,3%), un peso extremadamente bajo (39,8%) y sufrieron asfixia (38,7%). Las principales morbilidades fueron el síndrome de dificultad respiratoria (100%) y la sepsis (40,6%). El 55,9% de los prematuros extremos murieron. La mortalidad osciló entre el 26% a las 31 semanas y el 100% a las 22 semanas, con la mayoría (56,3%) entre las 22 y las 27 semanas. De las 266 muertes, 25 (9,3%) se produjeron en la sala de partos y 237 (89%) en la unidad neonatal. La tasa de mortalidad temprana fue de 0,77 muertes por cada 1.000 nacidos vivos y la tasa de mortalidad tardía fue de 0,22 muertes por cada 1.000 nacidos vivos. El límite de viabilidad fue de 28 semanas. Además de las características fetales, la muerte estuvo influida por una serie de factores susceptibles de intervención.
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Derechos de autor 2022 Patricia Fabiane Monteiro Laranjeira; Vanessa de Carla Batista dos Santos; Janaína da Silva Nogueira; Ana Clara Monteiro Laranjeira; Gabriel Monteiro Amorim; Rafael Monteiro Laranjeira; Kevan Guilherme Nóbrega Barbosa
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