Assuntos
Antibacterianos/análise , Antibacterianos/uso terapêutico , Monitoramento de Medicamentos/normas , Gentamicinas/análise , Gentamicinas/uso terapêutico , Programas de Rastreamento/normas , Sepse/tratamento farmacológico , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/tratamento farmacológico , Masculino , Programas de Rastreamento/métodos , Guias de Prática Clínica como AssuntoRESUMO
BACKGROUND: Weight gain in the first week of life is indicative of fluid excess in preterm neonates. AIMS: To determine if morbidity and/or mortality of extremely low birthweight (ELBW) infants was lower in those who did not have excess weight gain in the first week of life, compared with those who did. STUDY DESIGN: Retrospective cohort study. SUBJECTS: ELBW infants born from 1st May 2014 - 31st May 2019. EXCLUSIONS: major congenital abnormalities (including hydrops), died within the first 7 days, no recorded weight on day 6, 7 or 8. OUTCOME MEASURES: We compared infants whose weight was greater than birthweight by day 7 and infants whose weight remained at, or below, birthweight by day 7. RESULTS: There were 312 ELBW infants in the study population: 15 (5%) died before discharge from hospital. Holding birthweight and gestational age (GA) constant, the odds of death in neonates with day 7 weight >birthweight was about 3 times the odds of death in neonates with day 7 weight ≤birthweight (adjusted odds ratio 3.18, 95% confidence interval 0.66-15.26, p = 0.15). Neonates with day 7 weight >birthweight were more likely to have had a PDA that required treatment than those with day 7 weight ≤birthweight (65% versus 43% respectively; p <0.001). CONCLUSIONS: ELBW infants who gain weight in the first week of postnatal life, have a greater risk of PDA requiring treatment and may have a higher risk of mortality than infants who lose weight in the first week of life.
