Avaliação das repercussões da corticoterapia pré-natal em recém-nascidos em maternidade de referência de Manaus - AM

Abstract

Introduction: Prematurity is a serious problem for health services across the world, and the respiratory distress syndrome (RDS) is the largest lung problem during the neonatal period. The deployment of new technologies such as prenatal corticosteroids has shown an important role in reducing neonatal morbidity and mortality, in spite of few studies conducted in Brazil. Purpose: Evaluate the impact of antenatal corticosteroid on clinical outcomes of premature newborns. Methodology: Retrospective study of medical data collection of 24 newborns to 34 weeks of gestational age and their respective mothers, during the year of 2010 at Maternity "Balbina Mestrinho" in Manaus/AM. The sample was divided into four groups, considering the exposure of newborns to prenatal corticosteroid and the gestational age of them [Corticosteroids Groups (CG) ≤ 30 and 31 weeks ≥; and groups without Corticosteroid (GS) ≤ and ≥ 30 31semanas]. The GC and GS ≤ 30; GC and GS ≥ 31 were compared, considering the variables: incidence of RDS and its severity, use of exogenous surfactant, ventilatory support requirement, length of hospital stay and neonatal morbidity and mortality. The Generalized Fisher exact test and the binomial test and the Mann-Whitney were used by statistical software R2 .14 .1 with the packages and Deducer Rcmdr, considering a significance level of 5%. Results: the frequency of use of corticosteroid was 43,91% among pregnant women. The prenatal corticosteroids reduced the RDS diagnosis, but not its severity, in the GC ≥ 31 (p = 0.0028), as well as the need for exogenous surfactant administration (p = 0.0175), what was not seen in the GC ≤ 30. The corticosteroid did not reduce the use of ventilatory support or the number of days of its use, nor the time of hospitalization. There was no difference in the diagnosis of morbidity and mortality among newborns of same gestational range exposed to antenatal corticosteroid (p > 0.05). Conclusions: there was repercussion in favour of the use of antenatal corticosteroid in RDS reduction and the use of exogenous surfactant for newborns with a gestational age ≥ 31 weeks; on the other hand, such therapy did not influence the use and duration of ventilatory support, length of hospital stay and mortality rates between newborns of similar gestational range.