Analysis of Down syndrome newborn outcomes in three neonatal intensive care units in Rio de Janeiro, Brazil.

OBJECTIVE: The aim of this study was to analyze the outcomes of newborns with Down syndrome admitted to three neonatal intensive care units in the city of Rio de Janeiro, Brazil. METHODS: A retrospective cohort study was conducted by analyzing the medical records between 2014 and 2018 of newborns with Down syndrome admitted to three neonatal intensive care units. The following variables were analyzed: maternal and perinatal data, neonatal malformations, neonatal intensive care unit intercurrences, and outcomes. RESULTS: A total of 119 newborns with Down syndrome were recruited, and 112 were selected for analysis. The most common maternal age group was >35 years (72.07%), the most common type of delivery was cesarean section (83.93%), and the majority of cases were male (53.57%). The most common reasons for neonatal intensive care unit hospitalization were congenital heart disease (57.66%) and prematurity (23.21%). The most common form of feeding was a combination of human milk and formula (83.93%). The second most common malformation was duodenal atresia (9.82%). The most common complications during neonatal intensive care unit hospitalization were transient tachypnea of the newborn (63.39%), hypoglycemia (18.75%), pulmonary hypertension (7.14%), and sepsis (7.14%). The mean length of stay in the neonatal intensive care unit was 27 days. The most common outcome was discharge (82.14%). Furthermore, 12.50% of newborns were transferred to an external neonatal intensive care unit, and 6% died. CONCLUSION: Newborns with Down syndrome are more likely to be admitted to the neonatal intensive care unit, and the length of hospital stay is longer due to complications related to congenital malformations common to this syndrome and prematurity.

Análise dos achados neonatais no contexto da Síndrome de Down em três Unidades de Terapia Intensiva na cidade do Rio de Janeiro: um estudo retrospectivo de 5 anos / Analysis of neonatal findings in the context of Down Syndrome in three Intensive Care Units in the city of Rio de Janeiro: a 5-year retrospective study

Objetivo: Este estudo teve como objetivo principal analisar os achados neonatais de nascidos com Síndrome de Down internados em Unidades de Terapia Intensiva da cidade do Rio de Janeiro. Materiais e Métodos: Foram revisados os prontuários abertos entre os anos de 2014 e 2018 e coletadas informações perinatais, complicações neonatais, intercorrências de internação e desfecho. Resultados: Um total de 119 neonatos com SD foram recrutados, sendo selecionados 112 para a análise. A faixa de idade materna mais encontrada foi >35 anos (72,07%), a via de parto mais comum foi a cesariana (83,93%) e o sexo masculino representou a maioria dos casos (53,57%). A justificativa de internação mais comum foi malformação cardíaca (57,66%) e prematuridade (23,21%). O meio de nutrição mais utilizado foi a combinação de leite humano e fórmula (83,93%). A segunda malformação mais comum foi a Atresia de Duodeno (9,82%). As Complicações durante a internação hospitalar mais comuns foram Taquipneia (63,39%), Hipoglicemia (18,75%), Hipertensão Pulmonar (7,14%) e Sepse (7,14%). O tempo médio de internação na Unidade de Terapia Intensiva foi de 27 dias. O desfecho mais ocorrido foi o de Alta Hospitalar (82,14%). Foram transferidos para unidade externa 12,50% e evoluíram para óbito 6% dos casos. Discussão: Neonatos com SD têm maior probabilidade de serem admitidos em uma unidade neonatal e de permanecerem por período prolongado devido a complicações relacionadas a malformações congênitas comuns à síndrome e a prematuridade. Há a necessidade de novos estudos voltados para nascidos com Síndrome de Down a fim de aumentar a qualidade da assistência neonatal dos mesmos.

Aims: The main objective of this study was to analyze neonatal findings in medical records of children born with Down Syndrome (DS) admitted to three Intensive Care Units in the city of Rio de Janeiro. Materials and Methods: The medical records opened between the years of 2014 and 2018 were reviewed and perinatal information, neonatal complications, hospitalization complications and outcome were collected. Results: A total of 119 neonates with DS were found, however after the exclusion criteria 112 medical records were selected. The most common maternal age range was> 35 years (72.07%), the most common mode of delivery was cesarean section (83.93%) and the male gender represented just over half of the cases (53.57%) . The most common reason for hospitalization was due to heart disease (57.66%) and prematurity (23.21%). The most used means of nutrition was the combination of human milk and formula (83.93%). The most common malformation excluding heart disease was duodenal atresia (9.82%). The most common complications during hospitalization were Tachypnea (63.39%), Hypoglycemia (18.75%), Pulmonary Hypertension (7.14%) and Sepsis (7.14%). The average length of stay in the Intensive Care Unit was 27 days and despite the presence of congenital malformations, the most common outcome was Hospital Discharge (82.14%). 12.50% were transferred to an external unit and only 6% of the cases studied died. Discussion: Neonates with DS are more likely to be admitted to a neonatal unit and to remain for a prolonged period due to complications related to congenital malformations to the syndrome and prematurity. There is a need for further studies aimed at those born with Down Syndrome in order to increase the quality of neonatal care for them.