Incidence of neonatal near miss in a midsize maternity in the Northeast Brazil

Abstract

Objective: Verifying the incidence of neonatal near miss (NNM), an indicator of "near-death" due to pre or postnatal complications, in a medium-sized maternity hospital in the Northeast of Brazil. Study model: retrospective cohort, with an inductive approach and descriptive procedures. Method: Birth charts were analyzed during January 2016, and NNM cases were identified according to the following criteria: gestational age < 32 weeks, newborn (NB) requiring resuscitation or depressed maneuver, birth weight < 1500 g, need for care in a neonatal intensive care unit (NICU), need for mechanical ventilation, Apgar score at 1 and 5 minutes ≤ 7. To verify the association between maternal variables and NMN diagnosis the Student's t-test was used. Results: 120 NB were evaluated. Among them, 26 born of normal birth and 94 of cesarean delivery. The mean maternal age was 26.61 (± 7.9). The majority of the mothers had cardiovascular diseases (71.7%) and 70.8% had a prenatal visit with several consultations below seven. An incidence of 30% of NNM was observed, most of them male (55 %). The hospitalization rate in the NICU was 17.5%. The lower number of live children and higher mean cesarean births had a significant association (p <0.05) with the NNM. Conclusion: The NNM indicator presented a high incidence, even in a reference hospital for a high-risk pregnancy, being a highly relevant method for the evaluation and prevention of severe morbidity in the NB.