PULMONARY HEMORRHAGE INCIDENCE AND RISK FACTORS IN VERY LOW BIRTHWEIGHT NEWBORNS

INCIDENCE AND RISK FACTORS FOR PULMONARY HEMORRHAGE IN VERY LOW WEIGHT NEWBORNS

Abstract

Objectives: To determine the incidence of pulmonary hemorrhage (PH) and evaluate the associated risk factors in preterms ≤ 32 weeks gestational age and very low birthweight neonates. Methods: This is a longitudinal, observational and prospective study in which we analyzed data from preterms with ≤32 weeks gestational age and very low birth weight neonates admitted to a Neonatal Intensive Care Unit in Natal/RN, during October 2017 and September 2018. We have determined the pulmonary hemorrhage incidence and have analyzed the associated risk factors during pregnancy and neonatal period. The statistical analysis was descriptive and inferential using the Chi-square test, Student‘s T test and the multivariate logistic regression model. Results: 123 prematures were included in the study and 37 of them (30,1%) have developed PH. For those babies with PH the mean gestational age was 27,2 weeks and the mean birth weight was 875,5g. We found out to be important PH risk factors: lower gestational age and birthweight, absence of antenatal corticosteroid therapy, need for delivery room resuscitation, Apgar score in 5th minute < 7, admission temperature, use of surfactant therapy, persistent ductus arteriosus (PDA) and early onset sepsis. Only the absence of antenatal corticosteroid therapy, low birthweight and PDA remained significant after the multivariate logistic regression analysis. Conclusion: PH is a high incidence clinic event in prematures and very low birth weight neonates. The risk factors are associated with prematurity itself and inadequate assistance to pregnancy and premature labor, being extremely important to focus in a good perinatal care to avoid the development of such high morbidity and mortality disease. Keywords: Prematurity, Very low birth weight newborns, Antenatal corticosteroid, Pulmonary Hemorrhage, Persistent ductus arteriosus.