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Atenção à saúde de coorte de recém-nascidos prematuros tardios durante o primeiro ano de vida

  • Machado, Maria Cristina Heinzle da Silva...
Publication Date
Aug 31, 2018
Repositório Institucional UNESP
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Introduction: The premature newborns (gestational age at birth between 340/7 and 366/7 weeks), when compared to full-term infants (gestational age at birth ≥ 37 weeks), present greater vulnerability to becoming ill and dying, requiring special attention of health services. Objective: Analyze comparatively health care in the first year of cohort life of late and term premature newborns and outcomes regarding the use of referral health services and breastfeeding state in this period. Method: This study is a subproject of a prospective population-based cohort study that followed 656 infants and their mothers from July 2015 to February 2017, in Botucatu , state of São Paulo (CLaB study). The data were obtained at different moments, with the following sources: prenatal card, baby's card, children's chart and interviews with mothers in health care services, at home, personally, and by telephone. For the present study, 581 infants were included (540 full-term infants and 41 late premature infants) and being excluded premature and moderate premature newborns (gestational age at birth <34 weeks), and those who did not complete the planned follow-up. A univariate and multivariate analysis of the variables studied was performed, comparing the two groups, with significance assessed by the non-parametric Chi-square and Fisher Exact tests, calculating the 333odds ratio (OR) gross and (ORj) adjusted, adopting critical p <0.05. For these analyzes, the software Statistical Package for the Social Sciences (SPSS) V21 software was used. The research project was approved by the Research Ethics Committee (technical advice No. 1,089,594). Results: Late preterm infants were more likely to have low birth weight (p <0.001, OR = 28.16, 95% CI = 12.0-65.83), less prenatal performance in public service (p = 1,842 , OR = 0.50, 95% CI = 0.85-3.98), have not reached the minimum recommended number of prenatal visits (p=0,002; OR=4,21; IC 95% 1,67-10,60), the mothers did not stay with their children in the maternity ward (P <0.001, OR = 7.80, 95% CI 3.33-18.23), and having fewer records of Neuropsychomotor development during the first year of life. (P <0.001, OR = 2.33, 95% CI 0.90-6.06). As for the outcomes, there was a difference between the groups only regarding to the higher chance of preterm infants being admitted to the ICU in the maternity ward ( p <0.001, OR = 4.63, 95% CI 2.02- 10.64), their mothers had more knowledge about the duration indicated for exclusive breastfeeding (p = 0.045, OR = 2.17, 95% CI = 1 , 02-4,65) and failure to perform 22 breastfeed until leaving the maternity ward (p=0,001; OR=3,03; IC95%=1,53-5,99). Conclusion: In contrast to full-term infants, late preterm infants presented greater vulnerabilities than favorable birth situations, health care and promotion of breastfeeding, however, did not differ from them regarding the practice of breastfeeding and the use of referral services after discharge from the maternity ward until they completed one year of life

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