Clinical and epidemiological aspects of prematurity in a Normal Delivery Center, São Paulo, Brazil

Rabello, Miriam Siqueira do Carmo; Barros, Sonia Maria Oliveira de

doi:10.1590/S1679-45082011AO1874

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Original Article • EINSEinstein (São Paulo) 9 (4) • Oct-Dec 2011 • https://doi.org/10.1590/S1679-45082011AO1874 copy

Clinical and epidemiological aspects of prematurity in a Normal Delivery Center, São Paulo, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To present clinical and epidemiological aspects of prematurity in a Normal Delivery Center, and to describe outcomes.

Methods:

A cross-sectional retrospective study, with 189 medical records of premature, single, and living fetuses, with gestational ages between 25 and 36.6 weeks.

Results:

The prevalence of preterm births was 7.8%, and 23.2% in adolescent mothers. The most frequent obstetric complication was premature rupture of ovular membranes (35.4%), followed by hypertensive syndrome (18.5%). Cesarean section was performed in 33% of cases. The Apgar score in the 1st minute was < 7 in 36.0% of cases, and in the 5th minute of life, in 9.5% of cases.

Conclusion:

Among the aspects studied, results showed that the prevalence of preterm births was higher than expected for the adolescent mothers, however, with a satisfactory perinatal outcome.

Keywords:
Obstetrical nursing; Parturition; Natural childbirth; Obstetric labor, premature

Obstetric variables		n = 189	%	Mean ± SD (%)
Maternal age
	≤ 17	18	9.5
	18 \|-20	26	13.7
	20 \|-35	121	64.0
	≥35	24	12.8
	Total	189	100.0	25.5 ± 7.3
Parity
	0	74	39.2
	1 \|-3	70	37.0
	3 \|-5	34	18.0
	≥ 5	11	5.8
	Total	189	100.0	2.5 ± 1.8
Prior history of prematurity
	Yes	21	11.1
	No	168	88.9
Number of prenatal visits
	0	30	15.9
	1 \|-6	113	59.8
	≥ 6	46	24.3
	Total	189	100.0	4.0 ± 2.6

Complications	n^* * n =189.	%
PROM	67	35.4
Hypertensive syndrome	35	18.5
Oligoamnios	20	10.6
PMD	11	5.8
UTI	10	5.3
Diabetes	5	2.6

Variable		N	%	Mean ± SD(%)
Cervical dilation (cm)				3.7 ± 3.4
	≤ 2	85	45.0
	3 \|–\| 5	52	27.6
	6 \|–\| 8	26	13.7
	9 \|–\| 10	26	13.7
Amniotic membranes
	Intact	94	50.3
	Ruptured	92	49.2
	No record	3	1.6
Type of delivery
	C-Section	64	33.9
	Vaginal	125	66.1
	Total	189	100
Perineal conditions
	Intact	44	35.2
	1^st degree laceration	24	19.2
	2^nd degree laceration	0	0
	Episiotomy	57	45.6
	Total	125	100

Variable		n = 189	%
Gestational age (weeks)
	25 \| – 28	3	1.6
	28 \| – 31	10	5.3
	31 \| – 34	45	23.8
	34 \| – 36	131	69.3
Weight at birth (g)
	>1000	4	2.1
	1000 \|–1500	24	12.2
	1500 \|–2000	35	18.5
	2000 \|–2500	82	39.2
	≥ 2500	54	28.0
1^st minute Apgar
	≤ 7 (1 a 7)	68	36.0
	> 7 (8 a 10)	121	64.0
5^th minute Apgar
	≤ 7 (1 a 7)	18	9.5
	> 7 (8 a 10)	171	90.5
Final destination of the NB
	Hospital discharge	182	96.3
	Death	7	3.7
	Total	189	100.0

Destination	n	RF%
Rooming in with mother	86	45.5
NICU	103	54.5
Total	189	100.00

Weight at birth (g)	Gestational age (weeks)	Causes of deaths
710	25	Neonatal sepsis
850	26	Respiratory insufficiency, hyaline membrane pulmonary disease, pneumothorax on the right, and extreme prematurity
1140	29	Late sepsis, necrotizing enterocolitis, and clotting disorder
1700	31	Prematurity, neonatal anoxia, early cardiorespiratory insufficiency
1460	34	Septic shock, late neonatal sepsis, bronchopneumonia, prematurity, and hyaline membrane pulmonary disease
2230	34	Bilateral pneumothorax
2635	35	Severe pulmonary hypertension, early sepsis, moderate perinatal anoxia

Instituto Israelita de Ensino e Pesquisa Albert Einstein Avenida Albert Einstein, 627/701 , 05651-901 São Paulo - SP, Tel.: (55 11) 2151 0904 - São Paulo - SP - Brazil
E-mail: revista@einstein.br

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[1] Corresponding author: Sonia Maria Oliveira de Barros – Departamento de Enfermagem da Universidade Federal de São Paulo – Rua Napoleão de Barros, 754 – Vila Clementino – CEP 04024002 – São Paulo (SP), Brazil – Tel.: 11 5573-3371 – E-mail: sbarros@unifesp.br