Perfil de encaminhamentos pós alta de recém-nascidos em um hospital no interior do Rio Grande do Norte: um estudo retrospectivo

Abstract

Introduction: This study outlined a profile of newborns and investigated risk factors associated with neurodevelopmental alterations in neonates admitted to the University Hospital Ana Bezerra(HUAB). Early identification of these factors is essential for effective interventions. Objective: To delineate a profile of infants discharged after hospitalization in a hospital in a country town from Rio Grande do Norte State. Methodology: This is a retrospective cross-sectional study with data collection from medical records, covering newborns admitted between October 2023 and March 2024. Demographic data, maternal characteristics, neonatal conditions, and referrals for rehabilitation were analyzed. Descriptive statistics included frequencies and percentages, while statistical analyses involved normality tests, Mann-Whitney, and Chi-square tests. Results and Discussion: The sample included 253 newborns, 55.6% of whom were male. A total of 79.1% of births were full-term, and 82.4% were appropriate for gestational age. Among maternal risk factors, gestational hypertension (32.4%) and urinary tract infection (UTI) were predominant. Prematurity and neonatal jaundice were prevalent conditions among newborns, with the latter significantly associated with post-discharge to specialists (p=0.036). However, only 4% of infants were referred for rehabilitation, highlighting gaps in surveillance and referral pathways. The analysis revealed a lack of clear criteria for identifying and monitoring high-risk neonates. Well-documented risk factors such as maternal comorbidities (32.4%), low APGAR score at the 5th minute (6.5%), prematurity (20.9%), and neonatal jaundice diagnosis (51.4%) were observed in the study. Literature supports that these conditions may adversely impact neurological development. Conclusions: This study enabled the characterization of newborns' profiles, by identifying a population exposed to risk factors and, thus, facilitating the implementation of new strategies, whether through surveillance pathways or other measures adapted to the hospital’s reality. Therefore, the development of evidence-based protocols and multidisciplinary practices is recommended to promote comprehensive and equitable care for vulnerable newborns.