Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/1704
Title: Ruptura prematura das membranas amnióticas no pré-termo: fatores associados à displasia broncopulmonar
Other Titles: Preterm premature rupture of the fetal membranes: factors associated with bronchopulmonary dysplasia
Authors: Gonçalves, Danieli Dias
Silva, Luiz Guilherme Pessoa da
Paula, Glaucio de Moraes
Bonfim, Olga
Moreira, Maria Elisabeth Lopes
Assumpção, Augusta Maria Batista de
Figueira, Valéria Seild
Affilliation: Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Abstract: OBJETIVO: identificar os fatores obstétricos e neonatais associados ao desfecho de displasia broncopulmonar em pacientes com amniorrexe prematura no pré-termo. MÉTODOS: foram analisados 213 prontuários do Instituto Fernandes Figueira, entre 1998 e 2002, cujas pacientes evoluíram com quadro de amniorrexe prematura ≤34 semanas de gestação. Foram excluídas gestações múltiplas. As variáveis de natureza clínico-obstétricas e neonatais foram cotejadas com o desfecho de displasia broncopulmonar. Os dados foram submetidos à análise bivariada, sendo os valores que exibiam significância estatística (p≤0,05) submetidos à regressão logística. RESULTADOS: a prevalência de displasia broncopulmonar foi de 6.10%. A análise univariada dos fatores associados ao desfecho de displasia broncopulmonar exibiu os seguintes resultados: tempo de ventilação mecânica neonatal >10 dias (OR: 54,00 [11,55-278,25] p=0,000); idade gestacional <30 semanas (OR: 6,33 [1,26-43,06] p=0,017) peso ≤1.000 g (OR: 4,82 [1,34-17,53] p=0,010); peso ≤1.500 g (OR: 14,09 [1,82-300,50] p=0,003; persistência do canal arterial (OR: 12,33 [3,07-50,10], p=0,000); doença da membrana hialina (OR: 8,46 [2,21-35,00] p=0,000); pneumonia congênita (OR: 7,48 [2,03-27,93] p=0,000); uso de surfactante neonatal (OR: 19,66 [4,54-97,76] p=0,000) e infecção neonatal (OR: 7,67 [0,99-163,79] p=0,049). No modelo multivariado final, somente as variáveis “ventilação mecânica”>10 dias (p=0,001) e “uso de surfactante” (p=0,040) permaneceram independentemente associadas ao desfecho. CONCLUSÕES: observou-se que os fatores associados à displasia broncopulmonar são de natureza neonatal, sendo que a ventilação mecânica duradoura e o uso de surfactante neonatal influenciaram no desenvolvimento dessa doença.
Abstract: PURPOSE: to analyze obstetric and neonatal factors associated with bronchopulmonary dysplasia outcome in patients with preterm premature amniorrhexis. METHODS: we analyzed 213 medical records of patients of Fernandes Figueira Institute who suffered premature amniorrhexis (≤34 weeks of gestation) in the period from 1998 to 2002. Multiple gestations were excluded. Clinical-obstetric and neonatal variables were considered in relation to the bronchopulmonary dysplasia outcome. Data were subjected to bivariate analysis, and the values showing statistical significance (p≤0.05) were subjected to logistic regression analysis. RESULTS: the prevalence of bronchopulmonary dysplasia was 6.10%. Univariate analysis of the factors associated with the pulmonary dysplasia outcome were: neonatal mechanical ventilation for more than ten days(OR: 54.00 [11.55-278.25] p=0.000); birth gestational age of less than 30 weeks (OR: 6.33 [1.26- 43.06] p=0.017); birth weight ≤1,000 g (OR: 4.82 [1.34-17.53] p=0.010); birth weight £1.500 g (OR: 14.09 [1.82-300.50] p=0.003; patent ductus arteriosus (OR: 12.33 [3.07-50.10], p=0.000); hyaline membrane disease (OR: 8.46 [2.21-35.00] p=0.000); congenital pneumonia (OR: 7.48 [2.03-27.93] p=0.000); use of neonatal surfactant (OR: 19.66 [4.54-97.76] p=0.000), and neonatal infection (OR: 7.67 [0.99-163.79] p=0.049). In the final multivariate model, only the variables “neonatal mechanical ventilation”>10 days (p=0.001) and “use of a surfactant” (p=0.040) remained independently associated with bronchopulmonary dysplasia.CONCLUSIONS: the factors associated with bronchopulmonary dysplasia are related to neonatal features, asprolonged mechanical ventilation and the use of a surfactant influencethe development of thedisease.
Keywords: Fetal membranes, premature rupture
Risk factors
Infant
Bronchopulmonary dysplasia
Premature
Diseases
keywords: Ruptura prematura de membranas fetais
Fatores de risco
Doenças do prematuro
Displasia broncopulmonar
Issue Date: 2010
Publisher: Federação Brasileira das Sociedades de Ginecologia e Obstetricia
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Citation: GONÇALVES, Danieli Dias et al. Ruptura prematura das membranas amnióticas no pré-termo: fatores associados à displasia broncopulmonar. Rev. bras. ginecol. obstet., Rio de Janeiro, v. 32, n. 10, p. 497-503, out. 2010.
ISSN: 0100-7203
Copyright: open access
Appears in Collections:IFF - Artigos de Periódicos

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