Análisis del perfil de los recién nacidos con anoxia perinatal en la Unidad de Cuidados Intensivos Neonatales de una maternidad privada de Sergipe

Autores/as

DOI:

https://doi.org/10.33448/rsd-v12i10.43444

Palabras clave:

Asfixia neonatal; Hipoxia fetal; Perfil de salud.

Resumen

Objetivo: Evaluar el perfil de los recién nacidos con edad gestacional ≥ 35 semanas con anoxia perinatal en la Unidad de Cuidados Intensivos Neonatales (UCIN) de una maternidad privada de Aracaju, Sergipe. Metodología: Se trata de un estudio clínico observacional, descriptivo y transversal. Se utilizó una muestra de conveniencia, compuesta por todos los recién nacidos con edad gestacional ≥ 35 semanas, ingresados en UCIN desde el 1 de enero de 2019 al 31 de diciembre de 2020. Se excluyeron los neonatos fuera de la edad gestacional del estudio y los registros médicos incompletos. Se utilizó una puntuación de Apgar inferior a 7 en el minuto 5 para definir anoxia neonatal (AN). El análisis utilizó las pruebas Chi-Cuadrado de Pearson, Exacta de Fisher, Shapiro-Wilk, Mann-Whitney y Kruskal-Wallis, además de datos descriptivos. Se aplicó un nivel de significancia del 5%. Resultados: La muestra final estuvo compuesta por 127 niños, en su mayoría varones (63,7%), con peso normal al nacer (75,2%) y peso adecuado para la edad gestacional (79,6%). El peso medio y la edad gestacional media fueron 2.982,7 gramos (± 649,5) y 37,5 semanas (± 1,6), respectivamente. Los grupos con y sin AN no mostraron diferencias epidemiológicas significativas. Se encontró mayor riesgo de anoxia en los nacidos por vía vaginal (p=0,001) y en los que tuvieron eventos perinatales agudos (p=0,003). El tamaño pequeño para la edad gestacional fue un factor de riesgo para el resultado de muerte. Conclusión: Los eventos perinatales agudos y el parto vaginal son factores de riesgo para AN. Los recién nacidos pequeños para la edad gestacional tienen peores resultados. Podrían ser útiles futuros estudios que detallen los tipos de nacimiento para analizar la asociación con la AN.

Citas

Abrha, M. W., Asresu, T. T., Araya, A. A., & Weldearegay H G. (2019). Healthcare professionals’ knowledge of neonatal resuscitation in Ethiopia: analysis from 2016 national emergency obstetric and newborn care survey. International Journal of Pediatrics, 2019, 8571351. https://doi.org/10.1155/2019/8571351

Akker, T. V. (2019). Vacuum extraction for non-rotational and rotational assisted vaginal birth. Best Practice & Research Clinical Obstetrics & Gynaecology, 56, 47–54. https://doi.org/10.1016/j.bpobgyn.2018.12.002

Alves, T. L., Ribeiro Júnior, H. C., Costa, M. L., & Valois, S. S. (2015). Fatores associados ao recém-nascido pequeno para a idade gestacional: uma revisão. Nutrire: Revista da Sociedade Brasileira de Alimentação e Nutrição, 40(3), 376-382. https://doi.org/10.4322/2316-7874.04513

American Academy of Pediatrics (AAP), & American College of Obstetricians and Gynecologists (ACOG). (2015). The Apgar Score. Pediatrics, 136(4), 819-822. https://doi.org/10.1542/peds.2015-2651

American College of Obstetricians and Gynecologists (ACOG). (2014). Executive summary: neonatal encephalopathy and neurologic outcome. Obstetrics & Gynecology, 123(4), 896–901. https://doi.org/10.1097/01.AOG.0000445580.65983.d2

Apgar, V. (1953). A proposal for a new method of evaluation of the newborn infant. Current Researches in Anesthesia and Analgesia, 32(4), 260–267.

Bayih, W. A., Tezera, T. G., Alemu, A. Y., Belay, D. M., Hailemeskel, H. S., & Ayalew, M. Y. (2021). Prevalence and determinants of asphyxia neonatorum among live births at Debre Tabor General Hospital, North Central Ethiopia: a cross-sectional study. African Health Sciences, 21(1), 385-396. https://doi.org/10.4314/ahs.v21i1.49

Caramelo, I., Coelho, M., Rosado, M., Cardoso, C. M. P., Dinis, A., Duarte, C. B., Grãos, M., & Manadas, B. (2023). Biomarkers of hypoxic-ischemic encephalopathy: a systematic review. World Journal of Pediatrics, 19(6), 505-548. https://doi.org/ 10.1007/s12519-023-00698-7

Cavallin, F., Menga, A., Brasili, L., Maziku, D., Azzimonti, G., Putoto, G., & Trevisanuto, D. (2022). Factors associated with mortality among asphyxiated newborns in a low-resource setting. The Journal of Maternal-Fetal & Neonatal Medicine, 35(6), 1178-1183. https://doi.org/10.1080/14767058.2020.1743670

Chen, X., Chen, H., & Jiang, D. (2023). Maternal and Fetal Risk Factors for Neonatal Hypoxic-Ischemic Encephalopathy: A Retrospective Study. International Journal of General Medicine, 16, 537-545. https://doi.org/10.2147/IJGM.S394202

Derese, T., Belay, Y., & Tariku, Z. (2020). The Median Survival Recovery Time and Associated Factors Among Admitted Neonate in Intensive Care Units of Dire Dawa Public Hospitals, East Ethiopia, 2019. Annals of Pediatrics and Child Health, 8(8), 2–9. https://doi.org/10.47739/2373-9312/1201

Desalew, A., Semahgn, A., & Tesfaye, G. (2020). Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis. International Journal of Health Sciences, 14(1), 35-47.

Fernandes, V. L., Moura, M., Moreira, A., & Oliveira, T. (2020). Fatores de risco para asfixia perinatal em recém-nascidos atendidos em uma maternidade pública terciária. Residência Pediátrica, 10(2), 125-130. https://doi.org/10.25060/residpediatr-2020

Figueiredo, A. P. S. A., Almeida, V. S., Christoffel, M. M., Andrade, M., & de Melo, I. D. F. (2021). Cuidados de enfermagem ao recém-nascido com asfixia perinatal submetido à hipotermia terapêutica: uma revisão integrativa da literatura. Research, Society and Development, 10(1), e38910111893-e38910111893. http://dx.doi.org/10.33448/rsd-v10i1.11893

Gebremariam, H., Tesfai, B., Tewelde, S., Abay, S., Tekeste, D., & Kibreab, F. (2022). Demographic, Clinical Profile and Outcomes of Neonates Admitted to Neonatal Intensive Care Unit of Dekemhare Hospital, Eritrea. BMC Pediatrics, 22(1), 716. https://doi.org/10.1186/s12887-022-03779-0

Getaneh, F. B., Sebsbie, G., Adimasu, M., Misganaw, N. M., Jember, D. A., Mihretie, D. B., Abeway, S., & Bitew, Z. W. (2022). Survival and predictors of asphyxia among neonates admitted in neonatal intensive care units of public hospitals of Addis Ababa, Ethiopia, 2021: a retrospective follow-up study. BMC Pediatrics, 22(1), 262. https://doi.org/10.1186/s12887-022-03238-w

Gillam-Krakauer, M. G. J. C. (2020). Birth Asphyxia. British Medical Journal, 2, 2.

Grass, B., Scheidegger, S., Latal, B., Hagmann, C., Held, U., Brotschi, B., National Asphyxia and Cooling Register Group, & Follow-up Group. (2020). Short-term neurological improvement in neonates with hypoxic– ischemic encephalopathy predicts neurodevelopmental outcome at 18–24 months. Journal of Perinatal Medicine, 48(3), 296–303. https://doi.org/10.1515/jpm-2019-0391

Haksari, E. L., Hakimi, M., & Ismail, D. (2023). Neonatal mortality in small for gestational age infants based on reference local newborn curve at secondary and tertiary hospitals in Indonesia. BMC Pediatrics, 23(1), 214. https://doi.org/10.1186/s12887-023-04023-z

Jacobs, S. E., Berg, M., Hunt, R., Tarnow-Mordi, W. O., Inder, T. E., & Davis, P. G. (2013). Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database of Systematic Reviews, 2013(1), CD003311. https://doi.org/10.1002/14651858.CD003311.pub3

Jacobs, S. E., Morley, C. J., Inder, T. E., Stewart, M. J., Smith, K. R., McNamara, P. J., Wright, I. M., Kirpalani, H. M., Darlow, B. A., Doyle, L. W, & Infant Cooling Evaluation Collaboration. (2011). Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 165(8), 692-700. https://doi.org/10.1001/archpediatrics.2011.43

Kapaya, H., Williams, R., Elton, G., & Anumba, D. (2018). Can obstetric risk factors predict fetal acidaemia at birth? a retrospective case-control study. Journal of Pregnancy, 2018, 1–8. https://doi.org/10.1155/2018/2195965

Katz, J., Lee, A. C., Kozuki, N., Lawn, J. E., Cousens, S., Blencowe, H., Ezzati, M., Bhutta, Z. A., Marchant, T., Willey, B. A., Adair, L., Barros, F., Baqui, A. H., Christian, P., Fawzi, W., Gonzalez, R., Humphrey, J., Huybregts, L., Kolsteren, P., Mongkolchati, A., Mullany, L. C., Ndyomugyenyi, R., Nien, J. K., Osrin, D., Roberfroid, D., Sania, A., Schmiegelow, C., Silveira, M. F., Tielsch, J., Vaidya, A., Velaphi, S. C., Victora, C. G., Watson-Jones, D., Black, R. E.; & CHERG Small-for-Gestational-Age-Preterm Birth Working Group. (2013). Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis. Lancet, 382(9890), 417-425. http://dx.doi.org/10.1016/S0140-6736(13)60993-9

Katz, J., Wu, L. A., Mullany, L. C., Coles, C. L., Lee, A. C. C., Kozuki, N., & Tielsch, J. M. (2014). Prevalence of small for gestational age and its mortality risk varies by choice of birth weight for gestational reference population. PLoS ONE, 9(3), e92074. https://doi.org/10.1371/journal.pone.0092074

Kawakami, M. D., Sanudo, A., Teixeira, M. L. P., Andreoni, S., Castro, J. Q. X., Waldvogel, B., Guinsburg, R., & Almeida, M. F. (2021). Neonatal mortality associated with perinatal asphyxia: a population-based study in a middle-income country. BMC Pregnancy Childbirth, 21(1), 169. https://doi.org/10.1186/s12884-021-03652-5

Khalil, A. A., Morales-Rosello, J., Morlando, M., Hannan, H., Bhide, A., Papageorghiou, A., & Thilaganathan, B. (2015). Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission? American Journal of Obstetrics & Gynecology, 213 (1), 54. https://doi.org/10.1016/j.ajog.2014.10.024

Kune, G., Oljira, H., Wakgari, N., Zerihun, E., & Aboma, M. (2021). Determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, Central Ethiopia: A case-control study. PLoS One, 16(3), e0248504. https://doi.org/10.1371/journal.pone.0248504

Li, Z. N., Wang, S. R. & Wang, P. (2023). Associations between low birth weight and perinatal asphyxia: A hospital-based study. Medicine (Baltimore), 102(13), e33137. https://doi.org/10.1097/MD.0000000000033137

Limaso, A. A., Dangisso, M. H., & Hibstu, D. T. (2020). Neonatal survival and determinants of mortality in Aroresa district, Southern Ethiopia: a prospective cohort study. BMC Pediatrics, 20(1), 33. https://doi.org/10.1186/s12887-019-1907-7

Lisa, M., Cock, A. D., & Papile, L. A. (1983). Perinatal Asphyxia. Manual of neonatal care, 6, 518–527.

Liu, Q., Yang, H., Sun, X., & Li, G. (2019). Risk factors and complications of small for gestational age. Pakistan Journal of Medical Sciences, 35(5), 1199-1203. https://doi.org/10.12669/pjms.35.5.253

Meler, E., Mazarico, E., Eixarch, E., Gonzalez, A., Peguero, A., Martinez, J., Boada, D., Vellvé, K., Gomez-Roig, M.D., Gratacós, E., & Figueras, F. (2021). Ten-year experience of protocol-based management of small-for-gestational-age fetuses: perinatal outcome in late-pregnancy cases diagnosed after 32 weeks. Ultrasound in Obstetrics & Gynecology, 57, 62-69. https://doi.org/10.1002/uog.23537

Mendez-Figueroa, H., Truong, V. T., Pedroza, C., & Chauhan, S. P. (2017). Morbidity and Mortality in Small-for-Gestational-Age Infants: A Secondary Analysis of Nine MFMU Network Studies. American Journal of Perinatology, 34(4), 323-332. https://doi.org/10.1055/s-0036-1586502

Merchán-Haman, E., & Tauil, P. L. (2021). Proposta de classificação dos diferentes tipos de estudos epidemiológicos descritivos. Epidemiologia e Serviços de Saúde. 30 (1). https://doi.org/10.1590/s1679-49742021000100026

Nader, P., Ribeiro, E. M., Nomura, R., & Vieira, S. E. (2011). Recém-nascido Macrossômico. Sociedade Brasileira de Pediatria-Sociedade Brasileira de Genética Médica-Federação Brasileira de Associações de Ginecologia e Obstetrícia. Associação Médica Brasileira e Conselho Federal de Medicina.

Ogunkunle, T. O., Odiachi, H., Chuma, J. R., Bello, S. O., & Imam, A. (2020). Postnatal outcomes and risk factors for in-hospital mortality among asphyxiated newborns in a low-resource hospital setting: experience from North-Central Nigeria. Annals of Global Health, 86(1), 63. https://doi.org/10.5334/aogh.2884

Pérez, M. L. M., Garre, J. M. H., & Pérez, P. E. (2021). Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth. Frontiers in Pediatrics, 9, 650555. https://doi.org/10.3389/fped.2021.650555

Prior, T., & Kumar, S. (2014). Mode of delivery has an independent impact on neonatal condition at birth. European Journal of Obstetrics & Gynecology and Reproductive Biology, 181, 1359. https://doi.org/ 10.1016/j.ejogrb.2014.07.041

Procianoy, R. S., & Silveira, R. D. C. (2001). Síndrome hipóxico-isquêmica. Jornal de Pediatria, 77(1), S63-70. https://doi.org/ 10.2223/JPED.220

Puga, G. R., Piedade, A. B. S., Caldas, L. M., & Maciel, F. L. (2023). Hipotermia terapêutica em recém-nascidos com encefalopatia hipóxico-isquêmica: Uma análise da primeira infância. Research, Society and Development, 12(2), e16112240056-e16112240056. http://dx.doi.org/10.33448/rsd-v12i2.40056

Saenger P, & Reiter E. (2012). Genetic factors associated with small birth for gestational age and the use of human growth hormone in the treatment of the disorder. International Journal of Pediatric Endocrinology, 2012 (1), 12. https://doi.org/ 10.1186/1687-9856-2012-12

Sarnat, H. B., & Sarnat, M. S. (1976). Neonatal encephalopathy following fetal distress. Archives of Neurology, 33 (10), 696-705. https://doi.org/10.1001/archneur.1976.00500100030012

Sendeku, F. W., Azeze, G. G., & Fenta, S. L. (2020). Perinatal asphyxia and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Pediatrics, 20(1), 1–11. https://doi.org/10.1186/s12887-020-02039-3

Shah, P., Riphagen, S., Beyene, J., & Perlman, M. (2004). Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy. Archives of disease in childhood: Fetal and neonatal edition, 89(2), F152- F155. https://doi.org/10.1136/adc.2002.023093

Shankaran, S. (2012). Therapeutic hypothermia for neonatal encephalopathy. Current Treatment Options in Neurology, 14(6), 608-619. https://doi.org/10.1007/s11940-012-0200-y

Sociedade Brasileira de Pediatria (2009). Avaliação nutricional da criança e do adolescente. Manual de orientação. Departamento de Nutrologia.

Sociedade Brasileira de Pediatria (2020). Hipotermia Terapêutica. Manual de Orientação. Departamento Científico de Neonatologia. 4.

Szakmar, E., Jermendy, A., & El-Dib, M. (2019). Respiratory management during therapeutic hypothermia for hypoxic-ischemic encephalopathy. Journal of Perinatology, 39(6), 763-773. https://doi.org/10.1038/s41372-019-0349-2

Tegegnework, S. S., Gebre, Y. T., Ahmed, S. M., & Tewachew, A. S. (2022). Determinants of birth asphyxia among newborns in Debre Berhan referral hospital, Debre Berhan, Ethiopia: a case-control study. BMC Pediatrics, 22(1), 165. https://doi.org/10.1186/s12887-022-03223-3

Tenório, M. C. D. S., Mello, C. S., Santos, J. C. D. F., & Oliveira, A. C. M. D. (2020). Comparação da adequação do peso ao nascer para idade gestacional segundo diferentes curvas de crescimento intrauterino. Revista Brasileira de Saúde Materno Infantil, 19(4), 935-940. https://doi.org/10.1590/1806-93042019000400011

Tourinho, A. B., & Reis, M. L. B. S. (2012). Peso ao nascer: uma abordagem nutricional. Comunicação em Ciências da Saúde, 23 (1), 19-30.

Turner, J. M., Mitchell, M. D., & Kumar, S. S. (2020). The physiology of intrapartum fetal compromise at term. American Journal of Obstetrics & Gynecology, 222(1), 17–26. https://doi.org/10.1016/j.ajog.2019.07.032

Uleanya, N. D., Aniwada, E. C., & Ekwochi U. (2019). Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East. Nigeria African Health Sciences, 19(1), 1554–1562. https://doi.org/10.4314/ahs.v19i1.29

Wang, J., Tao, E., Mo, M., Ding, W., Yuan, J., Wang, M., Zheng, C., & Zheng, H. (2021). Perinatal Risk Factors Influencing Neonatal Hypoxic Ischemic Encephalopathy in Southern China: A Case-Control Study. American Journal of Perinatology, 38(01), e182-e186. https://doi.org/10.1055/s-0040-1708884

Zaigham, M., Helfer, S., Kristensen, K. H., Isberg, P. E., & Wiberg, N. (2020). Maternal arterial blood gas values during delivery: Effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood. Acta Obstetricia et Gynecologica Scandinavica, 99(12), 1674–1681. https://doi.org/10.1111/aogs.13936

Publicado

07/10/2023

Cómo citar

MATOS, A. C. G. de .; ALMEIDA, R. C. .; ANDRADE, T. V. de .; PAVIONE, M. A. . Análisis del perfil de los recién nacidos con anoxia perinatal en la Unidad de Cuidados Intensivos Neonatales de una maternidad privada de Sergipe. Research, Society and Development, [S. l.], v. 12, n. 10, p. e52121043444, 2023. DOI: 10.33448/rsd-v12i10.43444. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/43444. Acesso em: 23 dic. 2024.

Número

Sección

Ciencias de la salud