Risk Factors for Neonatal Death, Intraventricular Hemorrhage in Less Than 28 Gestational Weeks.

Abstract

Introduction: Complications derived from preterm birth are the main cause of infant mortality in the world. It is important to know the risk factors associated with preterm delivery to avoid future illnesses in surviving children.

Objective: Determine the risk factors for neonatal death and intraventricular hemorrhage in preterm births less than 28 weeks of gestation in the neonatal intensive care unit.

Material and methods: Cross-sectional study where we obtained records from the Hospital Español, Mexico City. For the descriptive analysis we calculated frequencies and percentages and 95% confidence intervals for the mother characteristics and the extreme preterm newborns. For the inferential analysis, we adjusted two multivariate logistic regression models, one taking intraventricular hemorrhage as a dependent variable and the other taking neonatal death as a dependent variable. The models were adjusted for the main perinatal and maternal factors

Results: Related to intraventricular hemorrhage we found that for each year that increases the maternal age, the probability of presenting intraventricular hemorrhage decreases 14%, for each gestation week that increases, the probability of intraventricular hemorrhage decreases 20% and the use of magnesium sulphate increased the probability of intraventricular hemorrhage 5.6 times more. 

Related to neonatal death we found that those who did not present neonatal sepsis, the probability of neonatal death decreased 92%, a higher grade of intraventricular hemorrhage, neonatal death probability 2.5 times more, for each gestation week that increases, the probability of neonatal death decreases 62% and the probability of neonatal death increased 62 times more in mothers than smoking during pregnancy.

Conclusion: Strategies should be established to prevent preterm delivery and maximize care at the time of birth.