Factores maternos, neonatales y relacionados con la atención, asociados con admisión a unidad de cuidado intensivo neonatal en recién nacidos a término en una clínica de Bogotá 2016

Abstract

Objective: The objective of the study was to identify the factors associated with the inflow of term infants to the Neonatal Intensive Care Unit (NICU)

Introduction: The neonatal care provided through the NICUs allows an optimal result in health care, not only in the preterm infants group frequently studied, but also in term infants, a group that is also vulnerable and increasingly represented in the stays Of NICUs, however this is an increasingly expensive practice and that in our countries with a limited health resource must be efficient in terms of the beds and the human resource required to provide this type of care.

Method: Case-control study defining as case: the newborn at term that enters NICU, and as control: the newborn at term without admission to the NICU. Sample: 94 cases and 376 matched controls by sex and by month of birth.

Statistical analysis: The association with the factors studied at the entrance to the NICU in the bivariate analysis was established through the calculation of adjusted Odds Ratio (OR) with estimation of their intervals and 95% confidence with the following results: instrumented delivery OR: 2.17 (1.087-4.35), neonatal weight under OR, 2.97 (1.54-5.71), social risk OR: 2.7 (1.6-4.5), chorioamnionitis OR: 10 , 26 (3.25-32.3), multiparous OR: 2.18 (1.3-3.4) and apgar under OR: 4.0 (1.15-13.8). The variables with the greatest significance were taken to the multivariate analysis and finally by means of the step-back method an explanatory model was applied as parsimonious as possible allowing the entry of variables: age over 35 years, low weight, diabetes and chorioamnionitis to the model Logistic regression.

Results: By means of conditional logistic regression, the event to be studied (newborn to term that enters the neonatal intensive care unit) was explained by the variables with greater association with the p value with statistical significance p <0.05, which were the Maternal age over 35, Chorioamnionitis, Diabetes Mellitus or Gestational Diabetes, and low birth weight newborns.

CONCLUSIONS: The logistic regression model included factors associated with NICU admission in term infants: age> 35 years OR 50.03 (15.60 to 160.4), low weight OR 5.3 (2 , 27 to 12,34), diabetes OR 4.7 (1.4 to 16.0) and chorioamnionitis OR 17.56 (4.32 to 71.33).