Abstract

BELLANI, Patricia  and  DE SARASQUETA, Pedro. Factores de riesgo de mortalidad neonatal, internación prolongada y predictores de discapacidad futura en una unidad de cuidados intensivos neonatales de alta complejidad. Arch. argent. pediatr. [online]. 2005, vol.103, n.3, pp.218-224. ISSN 0325-0075.

Introduction. There is very little information available about the impact that social, maternal, gestational factors and illnesses have in newborns referred to a highly complex NICU. Objectives. To establish mortality risk factors, prolonged hospitalization and predictors of high biological risk of future disability in NICU. Population, materials and methods. This was a prospective cohort study. All newborns admitted to the NICU between 11/1/2002 and 9/30/2003 were consecutively included. All those with malformations incompatible with life, as well as those admitted for treatment of retinopathy of prematurity were excluded. One of the authors collected data through the clinical records and an interview with the mother of each patient. The following were determined as dependent variables: mortality, prolonged hospitalization (>60 days), and predictors of high biological risk of future disability. Variables of social risk were also analyzed: mothers age and education, pregnancy control and unsatisfied basic needs. Variables of biological risk were: origin, transport, congenital malformations, mortality associated to diagnosis and complications during the hospitalization. The student's t and chi square tests were used for the univariate analysis, and logistic regression (forward stepwise conditional method; PIN= 0.05, POUT= 0.20) for the multivariate analysis. Results. 357 neonates took part of the research: 8.7% died, 13.7% had a high risk of disability and 11.2%, prolonged hospitalization. The following risk factors reached statistical significance in the multivariate analysis: maternal age >35 years, very low birth weight (<1,500 g), severity of illness at admission, congenital defects, avoidable surgical and infectious complications. Conclusions. Different factors of biological risk and quality of neonatal care were significantly associated with mortality, prolonged hospitalization and disability. Social and gestational factors were independent of the prognosis in the population studied except for maternal age. Our results suggest that the best intervention for improving the prognosis of neonates with very complex illnesses is to invest in neonatal intensive care.

Keywords : Neonatal mortality; Risk factors; Neonatal intensive care.

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