Respiratory morbidity in the first year of life of preterm infants discharged from a neonatal intensive care unit

Abstract

OBJETIVO: Verificar a incid??ncia de morbidade respirat??ria no primeiro ano de vida de prematuros de muito baixo peso e verificar se existe diferen??a na incid??ncia de morbidade respirat??ria no primeiro ano de vida segundo os fatores de risco neonatais. M??TODOS: O desenho foi de coorte prospectivo. Foram estudados neonatos com peso de nascimento inferior a 1.500 g e idade gestacional inferior a 34 semanas nascidos entre 1998 e 2000. As crian??as foram acompanhadas mensalmente no Ambulat??rio de Seguimento at?? os 12 meses de idade corrigida para a prematuridade. A cada consulta, foi verificada a presen??a de s??ndrome obstrutiva de vias a??reas e/ou pneumonia e/ou interna????o por problemas respirat??rios. Foi calculada a taxa de incid??ncia de morbidade respirat??ria ocorrida no primeiro ano de vida. Utilizou-se teste estat??stico para a diferen??a de propor????es (qui-quadrado). RESULTADOS: A amostra compreendeu 97 prematuros. As m??dias do peso de nascimento e da idade gestacional foram 1.113 g e 28 semanas. Durante o acompanhamento, 28% deles apresentaram s??ndrome obstrutiva de vias a??reas, 36% apresentaram pneumonia e 26% necessitaram de interna????o. Morbidade respirat??ria ocorreu em 53% das crian??as. Houve diferen??a significativa entre as taxas de morbidade respirat??ria nas crian??as que fizeram uso prolongado de oxig??nio (83%) e nas que n??o fizeram (43%). CONCLUS??O: Mais de 50% das crian??as acompanhadas apresentaram intercorr??ncia respirat??ria no curso do primeiro ano de vida. A incid??ncia de pneumonia e de interna????o foi elevada. As crian??as que fizeram uso prolongado de oxig??nio apresentaram significativamente maior taxa de incid??ncia de morbidade respirat??ria do que as crian??as que n??o usaram oxig??nio prolongadamente.OBJECTIVE: The objective of this study was to verify the incidence of respiratory morbidity in the first year of life in very low birth weight preterm infants and also to compare the presence of respiratory morbidity in the first year of life according to neonatal risk factors. METHODS: This is a prospective cohort study. We studied preterm newborn infants weighing less than 1,500 g and with gestational age less than 34 weeks who were born between 1998 and 2000. During the first year of life, the infants received monthly medical follow-up and during each visit we evaluated the patients considering the presence of obstructive airway syndrome and/or pneumonia and/or hospital admission due to respiratory conditions. The incidence rate of respiratory morbidity in the first year of life was measured. Chi-squared test was used to compare proportions. RESULTS: The cohort was constituted of 97 preterm infants with mean birthweight of 1,113 g and mean gestational age of 28 weeks. The incidence rates of obstructive airway syndrome, pneumonia and hospital admission were 28, 36 and 26%, respectively. The incidence rate of respiratory morbidity was 53%. There was a significant difference between the incidence rates of respiratory morbidity among infants who had a prolonged use of oxygen (83%) and those who did not (43%). CONCLUSION: More than 50% of the infants presented respiratory morbidity in the first year of life and there was a high percentage of pneumonia and hospitalization due to respiratory conditions. Infants who had a prolonged use of oxygen presented with higher respiratory morbidity incidence rate than infants who did not use oxygen for a long period