Morbidade respiratória neonatal e fatores associados ao óbito por síndrome do desconforto respiratório em unidades de terapia intensiva no município de Fortaleza

Abstract

The objectives of this study was to describe the profile and the standards of medical care in newborns with respiratory disorders admitted to intensive care units as well as analyze the risk factors associated to the death in low birth weight newborn with respiratory distress syndrome. It is a prospective cohort study hospitalar-based realized in 773 newborns in five hospitals from July and December 2007. Was two phases a described and the other, analytical. The majotity were premature (80.7%). Between the first and the fifth minute, the number of newborns with Apgar less than 3 decreased and the ones with Apgar above or equal to 7 increased. Respiratory distress syndrome was the most frequent disease (73%). For the newborns with very low weight and respiratory distress syndrome, 62.7% used mechanical ventilation, 53.7% surfactant and 19.9% died. The risk factors for death according to the bivariate analysis were: mother`s age less than 20 years (p=0.008), Apgar less than 7 in the fifth minute (p<0.001), the use of positive pressure ventilation in the delivery room (p<0.001), intubation in the delivery room (p<0,001) and the use of surfactant (p<0.001).The use of antenatal corticosteroids and use of surfactant was low. The newborns weighing less than 1500g needed more medical assistance than others and still presented a high death rate. According to the study, the respiratory disorders of the newborns and the outcome are strongly related to the prenatal factors, to the assistance in the delivery room and to the intensive care.