Associação entre esforço respiratório mensurado pelo Boletim de Silverman-Andersen e fatores clínicos e neuromotores em recém-nascidos hospitalizados

Abstract

Objective: To verify whether respiratory effort upon admission to a hospital neonatal unit is associated with clinical and neuromotor factors in hospitalized newborns. Methods: Prospective longitudinal observational study. 49 newborns hospitalized in a neonatal intermediate care unit were included. The Silverman-Andersen Bulletin (BSA) was used to measure respiratory distress, and the Prechtl Qualitative Assessment of Generalized Movements (GMA) was used to evaluate neuromotor responses through the global assessment of generalized movements (GMs). Independent clinical variables such as gestational age, birth weight, weight at discharge and length of hospitalization were also collected. Results: The proportion of newborns with respiratory distress was higher in those with birth weight less than 2500 g, compared to birth weight greater than or equal to 2500 g. The proportion of newborns with mild respiratory distress was higher in preterm than full-term infants. Furthermore, the proportion of newborns without respiratory distress was higher in those with a hospital stay of less than 30 days. The proportion of newborns with respiratory distress was higher in those with a discharge weight of less than 2500 g, compared to a discharge weight greater than or equal to 2500 g. In infants with a poor repertoire of GMs, there was a tendency (p=0.08) for a higher proportion of mild respiratory discomfort than without discomfort. Conclusion: Low birth weight, low discharge weight and prematurity were related to a greater tendency for respiratory distress in hospitalized newborns. GMs with a poor repertoire are marginally related to BSA, but in general there was no relationship between GMs and BSA.

Keywords: Neurodevelopmental disorders; Neonatal intensive care; Silverman Score