Intervenções na sala de partos em recém-nascidos de pré-termo com idade gestacional inferior a 27 semanas

Abstract

Background: The medical management of a preterm birth is a challenge and there is not a definite consensus on how to deal with this situation. The aim of this study was to evaluate the effect of delivery room (DR) management on clinical condition (temperature, peripheral oxygen saturation, blood glucose level, hemoglobin level, mean blood pressure and pH) on the NICU (Neonatal Intensive Care Unit) admission of preterm infants born before 27+0 weeks of gestational age (GA). Methods: This study was performed among all preterm infants with a GA between 23+0 and 26+6 weeks admitted to the level III NICU of Centro Hospitalar Universitário de São João between 1st January 2005 and 31th December 2018. Maternal demographics, gestation information, infants' characteristics, DR and NICU data were evaluated. Results: A total of 65 preterm neonates were included in this study. The admission pH was associated to the administration of epinephrine in DR [B= - 0.786; p = 0.003; 95%CI (-1.282)-(-0.290)]; blood glucose level to body weight on birth (B= 0.253; p = 0.006; 95%CI 0.078-0.428) and epinephrine in DR (B= 72.719; p = 0.02; 95%CI 12.530-132.908); body temperature to epinephrine administrated in DR [B= - 1.703; p = 0.001; 95%CI (-2.692)-(-0.714)]; and hemoglobin level to early CPAP in DR (B= 6.008; p = 0.013; 95%CI 1.356-10.660). Conclusions: DR procedures can have positive or negative effects on early outcomes of preterm newborns. It is crucial to research more about its impact to optimize the NICU management of this particular and challenging neonatal group.