Artículos de revistas
Admission hypothermia, neonatal morbidity, and mortality: evaluation of a multicenter cohort of very low birth weight preterm infants according to relative performance of the center
Fecha
2019-07-01Registro en:
European Journal Of Pediatrics. New York: Springer, v. 178, n. 7, p. 1023-1032, 2019.
0340-6199
10.1007/s00431-019-03386-9
WOS:000471701300007
Autor
Universidade Estadual de Campinas (UNICAMP)
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Inst Crianca
Univ Fed Rio Grande do Sul
Maternidade Hilda Brandao
Hosp Geral Pirajussara
Universidade Estadual Paulista (Unesp)
Universidade Federal de Uberlândia (UFU)
Univ Fed Maranhao
Pontificia Univ Catolica Rio Grande do Sul
Universidade do Estado do Rio de Janeiro (UERJ)
Inst Med Integral Prof Fernando Figueira
Fundacao Oswaldo Cruz
Universidade Estadual de Londrina (UEL)
Hosp Estadual Diadema
Univ Fed Parana
Universidade Federal de Minas Gerais (UFMG)
Hosp Estadual Sumare
Institución
Resumen
This prospective cohort study aimed to assess the association of admission hypothermia (AH) with death and/or major neonatal morbidities among very low birth weight (VLBW) preterm infants based on the relative performance of 20 centers of the Brazilian Network of Neonatal Research. This is a retrospective analysis of prospectively collected data using the database registry of the Brazilian Network on Neonatal Research. Center performance was defined by the relative mortality rate using conditional inference trees. A total of 4356 inborn singleton VLBW preterm infants born between January 2013 and December 2016 without malformations were included in this study. The centers were divided into two groups: G1 (with lower mortality rate) and G2 (with higher mortality rate). Crude and adjusted relative risks (RR) and 95% confidence intervals (95%CI) were estimated by simple and multiple log-binomial regression models. An AH rate of 53.7% (19.8-93.3%) was significantly associated with early neonatal death in G1 (adjusted RR 1.41, 95% CI 1.09-1.84) and G2 (adjusted RR 1.29, 95%CI 1.01-1.65) and with in-hospital death in G1 (adjusted RR 1.29, 95%CI 1.07-1.58). AH was significantly associated with a lower frequency of necrotizing enterocolitis (adjusted RR 0.58, 95%CI 38-0.88) in G2.Conclusion: AH significantly associated with early neonatal death regardless of the hospital performance. In G2, an unexpected protective association between AH and necrotizing enterocolitis was found, whereas the other morbidities assessed were not significantly associated with AH.