RESUMEN
PURPOSE: To identify obstetric and perinatal factors associated with perinatal morbidity and mortality in pregnancies that progressed with ruptured membranes. METHODS: A cross-sectional hospital-based study with secondary data from records of patients (n=87) that evolved with the premature rupture of membranes between 24 and 42 weeks of gestation, admitted from January to April 2013 to a public hospital in Acre State, North of Brazil. Data were subjected to bivariate analysis for selection of variables to be used in a multiple regression model according to Poisson logistic regression with robust error. RESULTS: The prevalence of perinatal morbidity-mortality was 51.4%, including a 2.3% death rate (2 cases) and a 9.2% fetal neonatal death rate (8 cases). The variables associated with mortality in the final multiple model were: number of prenatal consultations ≥6, with a prevalence ratio (PR) of 0.5 and a 95% confidence interval (95%CI) of 0.3-0.9, gestational age ≥30 weeks (PR=0.6; 95%CI 0.4-0.8), low birth weight (PR=2.9; 95%CI 1.5-5.4), and mechanical ventilation (PR=3.8; 95%CI 2.0-7.2). CONCLUSION: Perinatal morbidity and mortality were high among cases of ruptured membranes. Morbidity and mortality were associated with factors such as fewer prenatal visits, extreme prematurity and low birth weight in this group.
Asunto(s)
Rotura Prematura de Membranas Fetales/epidemiología , Enfermedades del Recién Nacido/epidemiología , Mortalidad Perinatal , Adolescente , Adulto , Estudios Transversales , Femenino , Hospitales Públicos , Humanos , Recién Nacido , Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJETIVO: Identificar os fatores obstétricos e perinatais associados à morbimortalidade perinatal em gestações que cursaram com amniorrexe prematura. MÉTODOS: Estudo transversal de base hospitalar, com dados secundários de prontuários de pacientes (n=87) que evoluíram com quadro de amniorrexe prematura com idade gestacional entre 24 e 42 semanas, definida pela ultrassonografia, e internadas no período de janeiro a abril de 2013 em uma maternidade pública no estado do Acre, região Norte do Brasil. Os dados foram submetidos à análise bivariada para seleção de variáveis que compuseram o modelo múltiplo utilizando a técnica de regressão logística de Poisson. RESULTADOS: A prevalência de morbimortalidade perinatal foi de 51,4%. Nesse total estão computados 2,3% de óbitos fetais (2 casos) e 9,2% de óbitos neonatais (8 casos). As variáveis que apresentaram associação no modelo múltiplo final com morbimortalidade foram: número de consultas de pré-natal ≥6, com razão de prevalência (RP) 0,5 e intervalo de confiança de 95% (IC95%) 0,3-0,9, idade gestacional ≥30 semanas (RP=0,6; IC95% 0,4-0,8), baixo peso ao nascer (RP=2,9; IC95% 1,5-5,4) e necessidade de ventilação mecânica (RP=3,8; IC95% 2,0-7,2). CONCLUSÃO: Observou-se elevada morbimortalidade perinatal entre casos que cursaram com amniorrexe prematura. A morbimortalidade esteve associada a fatores como menor número de consultas de pré-natal, extrema prematuridade e o baixo peso. .
PURPOSE: To identify obstetric and perinatal factors associated with perinatal morbidity and mortality in pregnancies that progressed with ruptured membranes. METHODS: A cross-sectional hospital-based study with secondary data from records of patients (n=87) that evolved with the premature rupture of membranes between 24 and 42 weeks of gestation, admitted from January to April 2013 to a public hospital in Acre State, North of Brazil. Data were subjected to bivariate analysis for selection of variables to be used in a multiple regression model according to Poisson logistic regression with robust error. RESULTS: The prevalence of perinatal morbidity-mortality was 51.4%, including a 2.3% death rate (2 cases) and a 9.2% fetal neonatal death rate (8 cases). The variables associated with mortality in the final multiple model were: number of prenatal consultations ≥6, with a prevalence ratio (PR) of 0.5 and a 95% confidence interval (95%CI) of 0.3-0.9, gestational age ≥30 weeks (PR=0.6; 95%CI 0.4-0.8), low birth weight (PR=2.9; 95%CI 1.5-5.4), and mechanical ventilation (PR=3.8; 95%CI 2.0-7.2). CONCLUSION: Perinatal morbidity and mortality were high among cases of ruptured membranes. Morbidity and mortality were associated with factors such as fewer prenatal visits, extreme prematurity and low birth weight in this group. .