Evaluation of the clinical risk index in very low birth weight newborns at a public tertiary maternity in the city of São Paulo, Brazil

• Main Authors: Pedro Alexandre Breuel, Conceição Aparecida de Mattos Segre
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2007-12-01
• Series: Einstein (São Paulo)
• Subjects: Neonatal mortality; Gestational age; Risk group; Birth weight; Infant; newborn
• Online Access: http://www.einstein.br/revista/arquivos/PDF/658-Einstein_P1_Vol5N4_Miolo_Pag.326%20a%20332.pdf

Objective: To evaluate the clinical risk index in very low birthweight newborns at a public maternity hospital, its associationwith mortality, some selected neonatal respiratory diseases andsurfactant therapy. Methods: A cohort prospective study carriedout at the Hospital Municipal Vila Nova Cachoeirinha e MaternidadeEscola, in São Paulo, Brazil. All newborns with gestational age< 31 weeks and birth weight < 1500 g were evaluated for theapplication of the clinical risk index for babies (CRIB). Newbornswho died in the first 12 hours of life or were referred from othermaternities were excluded from this study. Statistical analysesused logistic regression, Spearman correlation test and Student’st test. Results: Seventy-one cases were studied. The meangestational age was 27.30 ± 2.61 weeks; the mean weight was1032.61 ± 280.62 g. Birth weight and gestational age showedbetter predictive values for neonatal mortality than the clinicalrisk index for babies (80.30%, 76.10%, 73.20%). Twins showed nosignificant index differences (t = 0.601; p = 0.748). The scorewas inversely related to Apgar scores at 1 and 5 minutes and wasassociated with the respiratory distress syndrome, pneumothoraxand the use of surfactants. There was no significant correlation withchronic lung disease. Conclusion: The clinical risk index for babieswas not the best predictor for neonatal mortality as compared toweight and gestational age, but showed a significant associationwith 1 and 5-minute Apgar scores, respiratory distress syndrome,extrapulmonary air and the use of surfactants. It was not predictivefor chronic lung disease. Twins were not associated with CRIB.