Perfil das internações e dos desfechos clínicos em uma unidade pública de terapia intensiva neonatal: Impacto da pandemia por COVID-19

Abstract

Introduction: The neonatal period is characterized by great vulnerability due to biological, environmental, socioeconomic and cultural risks. The Neonatal Intensive Care Unit (NICU) is an intensive care unit for neonates who need support or whose life is at risk. There are several causes that lead to the hospitalization of the newborn (NB), which are directly related to some pre, intra or postpartum complication. With the COVID-19 pandemic, several changes and adaptations occurred in peri and neonatal care, due to the restriction measures adopted. Objective: This study aimed to characterize the hospitalization profile of NBs and their clinical outcomes in a public Neonatal Intensive Care Unit, analyzing the impact of the pandemic due to the new Coronavirus on the neonatal context. Methodology: This is an epidemiological, retrospective, descriptive cross-sectional study, carried out through data collection in the medical records of newborns admitted to the Neonatal Intensive Care Unit of the University Hospital of the Federal University of Grande Dourados. hospitalization in the NICU occurred from November 2019 to December 2021, excluding medical records of NBs of indigenous ethnicity. Data collection was carried out in November and December 2022. Results: In all, data from 476 newborns were included in the survey, with data referring to the period considered pre-pandemic (November 2019 to February 2020) and pandemic (March 2020 to December 2021) being analyzed separately. The sample referring to the pre- pandemic period consisted of data from 68 NBs, while the sample for the pandemic period was composed of 408 NBs. Differences were found between periods regarding adherence to prenatal care, route of birth, average number of hospitalizations, need for ventilatory support and clinical outcomes. Conclusion: From the data found and analyzed in this study, it can be observed that the COVID-19 pandemic had a direct impact on the adherence of pregnant women to prenatal care. In addition, the pandemic context had an indirect impact on the profile of hospitalizations and neonatal clinical outcomes of the studied population. This impact occurred mainly through the increase in the percentage of cesarean sections performed, in neonatal respiratory changes, in the need for neonatal ventilatory support and in neonatal deaths. In addition, it is clear the need for further studies to be possible to observe whether the impact of the pandemic occurred in a similar way in other parts of the country.