Fatores associados à indicação de oxigenoterapia de longa duração (OLD) em recém-nascidos com displasia broncopulmonar: estudo de coorte restrospectiva

Abstract

Bronchopulmonary dysplasia (BPD) is the most common of premature birth and can result in hospital discharge requiring long-term oxygen therapy (LTOT). Although LTOT is an interesting therapeutic option in some cases, the hospital discharge in room air is more advantageous from a clinical, budget and family management point of view. Objective (s): Identify, among the maternal, peri and postnatal health conditions of newborns, the risk factors for hospital discharge requiring LTOT. Methods: In a retrospective cohort, displaced babies admitted to the largest maternity hospital in Minas Gerais between January / 2014 and July / 2019, had their gestation, birth and hospitalization history collected from the Vermont Oxford Network (VON). The relative risk to each variable were calculated using a multivariate logistic regression model. Results: Of the 665 babies who met the inclusion requirements, 6.51% were discharged from LTOT. The risk factors found for LTOT were: chorioamnionite RR 5.24 (95% CI 1.42, 19.34), fetal malformation RR 3.49 (95% CI 1.30, 9.37), late onset sepsis RR 3.31 (95% CI 1.57, 6.98) and maternal hypertension RR 2.26 (95% CI 1.06, 4.84). The institution of the Continuous Positive Airway Pressure (CPAP) protocol in the delivery room was protected for LTOT RR 0.23 (95% CI 0.00, 0.39). Conclusion: The health conditions identified as risk factors for LTOT are intervention persible, encouraging actions to promote and protect health during pregnancy and birth. The use of CPAP in the delivery room, identified as a protective action for OLD, should be encouraged in all institutions that provide care services to the neonatal population.