Comparação das internações em unidade de terapia intensiva neonatal e a estratificação de risco gestacional do Programa Rede Mãe Paranaense – contribuições para a Saúde Pública.

Abstract

The objective of this study is to compare the gestational risk stratification of the Parana’s Mother Network Program and its relationship with the hospitalizations of newborns in the Neonatal Intensive Care Unit. A quantitative, longitudinal, epidemiological study of the cohort type was carried out, with follow up of hospitalizations of newborns in the neonatal intensive care unit of the Hospital Universitário Regional dos Campos Gerais in the year 2016. It was used a data collection instrument, applied to the parents, after the acceptance of the Free and Informed Consent Term. Data can also be obtained by documentary analysis in medical records. The data obtained were mapped on Excel, and statistical analysis was carried out using the STATA Program. The target group consisted of 70 newborns who were admitted to the Neonatal Intensive Care Unit and compared with the gestational stratification of their mothers. The maternal population was composed of white women (76%), with a primary and secondary schooling level and with an average age of 25 years. The salary bands found most frequently, according to the IBGE criteria, were up to 4 minimum wages according to the IBGE criteria. The current deliveries were mostly hospital and with a discreet predominance of vaginal deliveries. About 100% of pregnant women had prenatal consultations, and 68% performed more than 5 consultations during pregnancy. In relation to the newborn population, 58% were premature, as compared to 42% of full-terms. Approximately 46% were born with Apgar score greater than 8 in the first minute. The birth weight ranged from 670 to 4385 grams. The mean hospitalization was 20 days, ranging from 14 days in the full-term patient to 23 days in the preterm patient. Regarding the comparison of hospitalizations in relation to gestational stratification, 65,72% were those at usual risk. A correction in the study of the stratification was performed, which was called corrected. The correction applied was by race, age and number of previous deliveries and presence of abortion. A risk association analysis was performed and although a risk ratio was found in some cases, with values lower than 1, simulating protection for some exposures, the p value was not significant. The same did not occur for the diagnostic outcome, where the p-value was 0,01 and 0,05 for the stratification found and corrected. The most frequent cause of hospitalization was the respiratory rate (p= 0,001) and hypoxia, in premature newborns and full-term, respectively. In linear regression analysis, it was observed that the increase in a week on gestational age of premature infants increases the apgar of the first minute. Many studies must be conducted on the subject, in order to mobilize health managers on these new Public Health Policies in order to minimize preventable neonatal deaths.