PREDICTOR VARIABLES OF NEONATAL MORTALITY IN VERY-LOW-BIRTH-WEIGHT INFANTS

The aim of this study is to investigate the mortality profile in very-low-birth-weight infants, as well as model the association of some variables with neonatal mortality, in order to detect possible preventable causes of death. This retrospective cross-sectional study included a total of 109 Very-Low-Weight-Infants admitted to a Neonatal Intensive Care Unit in a municipality in Minas Gerais, Brazil, between January 2012 and December 2016. The neonates were divided into two groups: death and non-death. Frequency distributions were constructed for the variables maternal age, sex, birth weight, gestational age, type of delivery, asphyxia (Apgar at five minutes), administration of antenatal corticosteroids, hypothermia, twinning, and amniotic membrane rupture. The survival curve was plotted using the Kaplan-Meier non-parametric estimator, and theassociation between death and the observed explanatory variables was modeled via Logistic Regression. In the survivor group, most infants exhibited normothermia and weight ≥1,000g. As for the death group, weight below 1,000g and hypothermic infants were predominant. In both groups, maternal age between 18 and 35 years prevailed, as well as the male sex, gestational age of 224 days, cesarean delivery, and fifth minute Apgar scores ≥7. The survival rate, estimated using the Kaplan-Meier method, showed a decrease from 1.0 to 0.55 at the beginning of the observation period. The adjusted logistic regression model included fetal weight and the fifth minute Apgar score. No significant relationship was found between death and the variables type of delivery, hypothermia, and antenatal corticosteroid use.Logistic regression indicated a high probability of death associated with birth weight and the Apgar score at five minutes. The low association with the other variables may be related to the good quality of prenatal, intrapartum, and postpartum care provided in the region and the analyzed hospital.