Risk factors associated with neonatal pulmonary haemorrhage
Keywords:
pulmonary hemorrhage, risk factorsAbstract
Objective: to determine the prevalence of pulmonary bleeding in patients admitted to neonatal intensive care and identify associated risk factors. Methodology: case-control study in patients with ventilatory support and a confirmed pulmonary hemorrhage diagnosis, with predefined inclusion criteria. Controls were matched by sex and selected in relation to the following entry in the Neonatology Intensive Care Unit after a case with a weight difference of ± 200 g and a gestational age of ± 1 week. Associated characteristics to the clinical features were identified and divided into prenatal and postnatal factors. The selection and analysis of data were made with the SPSS statistical basis; descriptive statistics were used and crossing variables with odds ratio evaluation were performed for the analysis. The problem's prevalence was also calculated. Results: a total of 1039 patients were treated at the Neonatal ICU, where we recorded 17 cases of pulmonary hemorrhage, with inclusion criteria defined, there were taken 12 that matched with 24 controls. The prevalence of pulmonary hemorrhage was 1.15% with a mortality of 66.7%. From all the cases, pulmonary hemorrhage occurred in 33.3%, in patients with less than 1500 g and in 83.3% of preterm infants, particularly in those under 32 weeks. They were identified as risk factors not to use steroids for lung maturity during the pregnancy (OR 1.73 CI 1.40 to 7.36 p 0.45), persistent pulmonary hypertension (OR 1.73 CI 1.40-7.36 p 0.45), hyaline membrane disease (OR 2.0 CI 1.47 to 8.46 p 0.34) and the use of exogenous surfactant therapy for the management of it (OR 3 40 CI 1.80 to 14.41 p 0.09). Independently, disseminated intravascular coagulopathy, had more relevant statistical significance as a cause (OR 35.0 CI 5.02 to 93.85 p 0.01). Conclusion: pulmonary hemorrhage is a poor prevalent complication with a high mortality, in which gestational age and associated factors to the immediate management of prematurity complications are essential to improve the prognosis.
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