Assessment of morbidity and mortality in newborns with late prematurity: experience of a reference maternity in the northeast of Brazil.

BACKGROUND: Late preterm infants show high rates of adverse perinatal outcomes. The aim of this study is to assess the morbidity and mortality of newborns (NBs) with late preterm birth in a reference maternity hospital in northeastern Brazil. METHODS: Retrospective cohort study from March 1st to July 15th, 2017. A total of 204 NBs with gestational age between 34 and 36 weeks and six days were evaluated and compared to 205 full-term NBs (39 and 40 weeks and six days). Perinatal outcomes including neonatal morbidity were evaluated. The Student's t and ANOVA tests were used for normal variables, and the Wilcoxon, Mann-Whitney and Kruskal-Wallis tests for non-normal variables. RESULTS: Late preterm infants showed significant higher rates of hypothermia, hypoglycemia, respiratory distress syndrome, jaundice in need of phototherapy (67.6%), admission to the neonatal intensive care unit (ICU), and difficulty breastfeeding compared to full-term NBs (P<0.001). Respiratory distress was the main indication for the admission of late preterm infants (P<0.001) to neonatal ICU. Late preterm infants had a longer hospital stay (6.9 vs. 3.7 days, P<0.001). There were three deaths in the group of late preterm NBs, and none in the group of term NBs. CONCLUSIONS: Late preterm NBs presented higher rates of morbidity and mortality when compared to full-term NBs.

Endothelial dysfunction after pregnancy-induced hypertension.

OBJECTIVE: To carry out long-term analysis of the presence of endothelial dysfunction after the development of pregnancy-induced hypertension (PIH). METHODS: In a retrospective cohort study, data were analyzed from 60 women who delivered at a tertiary maternity hospital in Fortaleza, Ceara, Brazil, between 1992 and 2002. Thirty women had a history of PIH and 30 had no history of complications. Anthropometric and laboratory data were collected, and endothelial function was evaluated by flow-mediated dilatation of the brachial artery. Continuous variables were analyzed via Student t test, and Mann-Whitney test was used to compare means. Clinical and metabolic measures were categorized according to cardiovascular risk by cutoff points determined by national consensus; χ2 and Fisher exact tests were used to compare the groups. Relative risk was calculated for variables that were statistically significant (P<0.05). RESULTS: Women with a history of PIH had higher body mass index (P=0.03), systolic blood pressure (P=0.03), low-density lipoprotein cholesterol (P=0.02), and fasting glucose (P=0.02) compared with women with no pregnancy complications. The frequency of endothelial dysfunction was 60% among all women, with a significant difference between the 2 groups (P=0.01). CONCLUSION: Women with a history of PIH were found to have a higher frequency of long-term endothelial dysfunction.

Mortalidade materna por cadiopatia / Maternal mortality due to heart disease

Realizou-se estudo retrospectivo da mortalidade materna por cadiopatia, no período de janeiro de 1979 a dezembro de 1989. Dentre um total de 16.423 internaçöes, houve 694 gestantes com o diagnóstico de cardiopatia (4,2%). No mesmo período, ocorrerram 51 óbitos maternos, correspondendo a um coeficiente de mortalidade materna de 428,2/100.000 nascidos vivos. Houve 12 óbitos maternos por cardiopatia. A análise estatística permitiu a identificaçäo de alguns fatores associados a maior risco de morte nas pacientes cardiopatas: primeira gravidez, primiparidade, ausência de assistência pré-natal, realizaçäo de cirurgia cardíaca anterior à gravidez e/ou gestaçäo. O maior número de mortes ocorreu no puerpério. A classificaçäo funcional (NYHA) näo se constituiu em parâmetro seguro para avaliar o prognóstico materno, pois 91,7 por cento dos casos de óbito foram incluídos no grupo considerado favorável (classes I e II) ao iniciar a gestaçäo