Produção Nacional
Revisado por pares
Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists
2012; Springer Nature; Volume: 32; Issue: 12 Linguagem: Inglês
10.1038/jp.2012.28
ISSN1476-5543
AutoresRuth Guinsburg, Maria Fernanda Branco de Almeida, Lílian dos Santos Rodrigues Sadeck, Sérgio Tadeu Martins Marba, Lígia Maria Suppo de Souza Rugolo, Jorge Hecker Luz, José Maria de Andrade Lopes, Francisco Eulógio Martinez, Renato S. Procianoy,
Tópico(s)Maternal and Neonatal Healthcare
ResumoTo verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Prospective cohort of 484 infants with 230/7 to 266/7 weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ⩾1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life. Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions. In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day.
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