Evolução nutricional de crianças acompanhadas em um ambulatório de follow up de uma maternidade pública do Rio de Janeiro

Abstract

The increase of prematurity prevalence and the advances in neonatology led to an increase in the survival rates of high risk long-term morbidities neonates. It is essential to provide continued care and to evaluate survivors in follow-up services. This is a descriptive retrospective longitudinal study conducted at the outpatient Follow up of a public maternity in Rio de Janeiro, by accessing the information from the medical records of children and their mothers.The majority of mothers of premature infants were aged 20 to 35 years old, had eutrophy prepregnancy, major complications such as hypertension and diabetes and most of them had caesarean birth (66.2%). Most of the children were male (64.6%) and were born with more than 1,500 g, the frequency of SGA being 24.6%. The average apgar score was 6 and 8 in 1 and 5 minutes respectively. The length of stay in the neonatal ICU ranged from 6 to 241 days (51.1 days average). The main complications during hospitalization were related to the respiratory tract. During hospitalization 27.7% of children passed through the 2nd stage of the Kangaroo Method. The time between the discharge and the beginning of the Follow up was, on average, 18 days. At the beginning of the ambulatory monitoring most children were breastfed exclusively (47.4%). There were decreases of nutritional status of children to term, according to classification by intrauterine growth curves. But after a year of follow-up, nutritional recovery had occurred already for most children, being the average of the indicators, length for age, weight for age, weight for age and BMI for age indicating adjustment of all parameters. It was observed, after a year of monitoring a small percentage of children in surveillance for high BMI and overweight. Information about complementary feeding, data on age of introduction, type and consistency of food, introduction of water, were not found in the vast majority of medical records. To ensure that high risk neonantes develop all their potential, it is imperative that they are accompanied on multidisciplinary Follow up programs. This way, they can be evaluated and receive the necessary care to ensure a healthy development and growth.