Resumo:
En
|
Texto:
En
|
PDF:
En
Abstract Objective: To evaluate the conservative management of newborns born at ≥35 weeks of gestational age, at risk for early-onset neonatal sepsis (EOS). Methods: Retrospective, analytic cohort study (2016 to 2019), including newborns ≥35 weeks of gestational at risk of EOS, asymptomatic at birth, managed conservatively in full rooming-in: serial physical examination and clinical observation for at least 48 h. They were classified into three groups, according to the clinical course: asymptomatic (group A), symptomatic for other reasons (group B), and with sepsis (group C). Risk factors, clinical signs and differential diagnoses of sepsis, length of stay, and discharge conditions were evaluated. Results: The authors evaluated 769 asymptomatic newborns at risk of EOS. (mean birth weight 2999 ± 485 g and gestational age 37.6 ± 1.7 weeks, respectively) corresponding to 12.2% of rooming-in admissions. The most prevalent risk factors were colonization by Group B Streptococcus (29%), prolonged rupture membrane duration (21.9%) and preterm labor (21.4%). Most of all of them (53.9%) remained asymptomatic (group A). Group B corresponded for 45.3%, and the most common clinical signs were hypothermia (24.5%), tremors (8.7%) and vomiting (8%). Environmental dysthermia (50.7%), prematurity (20.0%), and feeding intolerance (15.7%) were common in Group B. Laboratory tests were performed in 3.5%. Five patients (one confirmed) comprised group C (0.8/1,000 live births). There were no deaths. The median length of stay was 64 h (IQR 50-93). Conclusion: The rate of clinical/confirmed EOS was low. Most of the symptomatic patients only needed clinical evaluation to rule out sepsis. Management was shown to be safe. Objective 35 ≥3 earlyonset early onset . (EOS) Methods Retrospective 2016 (201 2019, 2019 , 2019) roomingin rooming 4 groups course A, A A) B, B) C. C) Results 76 mean 299 376 37 6 37. 17 1 7 1. respectively 122 12 2 12.2 admissions 29%, 29 29% (29%) 21.9% 219 21 9 (21.9% 21.4%. 214 21.4% (21.4%) 53.9% 539 53 (53.9% A. 453 45 3 45.3% 24.5%, 245 24.5% 24 5 (24.5%) 8.7% 87 8 (8.7% 8%. 8% (8%) 50.7%, 507 50.7% 50 (50.7%) 20.0%, 200 20.0% 20 0 (20.0%) 15.7% 157 15 (15.7% 3.5% one confirmed 0.8/1,000 081000 000 (0.8/1,00 births. births births) deaths IQR 5093. 5093 93 50-93) Conclusion clinicalconfirmed low safe ≥ (EOS 201 (20 12. (29% 21.9 (21.9 21.4 (21.4% 53.9 (53.9 45.3 24.5 (24.5% 8.7 (8.7 (8% 50.7 (50.7% 20.0 (20.0% 15.7 (15.7 3.5 0.8/1,00 08100 00 (0.8/1,0 509 50-93 (2 (29 21. (21. (21.4 53. (53. 45. 24. (24.5 8. (8. (8 50. (50.7 20. (20.0 15. (15. 3. 0.8/1,0 0810 (0.8/1, 50-9 ( (21 (53 (24. (50. (20. (15 0.8/1, 081 (0.8/1 50- (5 (24 (50 (1 0.8/1 08 (0.8/ 0.8/ (0.8 0.8 (0. 0. (0