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Type: Artigo
Title: Proactive management of extreme prematurity : disagreement between obstetricians and neonatologists
Author: Guinsburg, R
Almeida, M F Branco de
Sadeck, L Dos Santos Rodrigues
Marba, S T M
Rugolo, L M Suppo de Souza
Luz, J H
Lopes, J M de Andrade
Martinez, F E
Procianoy, R S
Abstract: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ≥1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life. Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions. In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day
Subject: Prematuro
Country: Reino Unido
Editor: Nature
Rights: Fechado
Identifier DOI: 10.1038/jp.2012.28
Date Issue: 2012
Appears in Collections:FCM - Artigos e Outros Documentos

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