Desfechos dos recém-nascidos submetidos à profilaxia com palivizumabe

Abstract

Prematurity is a challenging public health problem worldwide and in Brazil and is considered the leading cause of death in children in the first five years of life. Infants under six months of age, especially premature infants, children with chronic lung disease of prematurity and heart disease are the population at greatest risk of developing severe respiratory infection, with respiratory syncytial virus (RSV) being one of the main causes. Due to the high morbidity and mortality associated with RSV-related infections and the high costs of treatments due to hospitalizations, this research was of fundamental importance, which aims to evaluate the outcomes of children undergoing prophylaxis with Palivizumab. This is a retrospective, documentary, quantitative cohort study that was developed in a tertiary maternity hospital with all newborns admitted to the Neonatal Unit and who were elected to receive prophylaxis with Palivizumab, during the seasonal period, during hospitalization and/or after hospital discharge, between January 2018 and July 2023. Children whose medical records were incompletely filled out were excluded. The data collection instrument consisted of neonatal variables (sex, birth weight, APGAR score, gestational age, birth diagnosis) and clinical variables: number of doses of Palivizumab administered, number of times the child was affected by respiratory infection, incidence of hospitalization for respiratory infection and use or not of oxygen therapy. Data collection was performed in the institution's physical medical records. The data were entered and analyzed in the Excel® and R® programs, and tables and graphs were constructed. The D' Agostino Pearson tests were performed to verify normality, when the non-parametric distribution was used the Kruskal -Wallis and Wilcoxon tests , to verify the association the Fisher's exact test and the Kendall test for correlation, the results expressed as mean and median, with data that presented a p-value <0.05 being considered significant. The ethical guidelines for research with human beings were respected, and the identity of the child and guardian was ensured and preserved during the dissemination of the research results. Results: 77 (73.0%) children had the first ARI in the first year of life, with a median of 3.0 doses of Palivizumab; 84 (79.0%) children became ill but were not hospitalized; 28 (65.0%) children had the second ARI in the second year of life and with a median of 4.0 doses and 36 (84.0%) children who became ill but were not hospitalized; 225 (75%) children did not get sick in the first year of life and 155 (51.3%) children received a complete prophylaxis regimen with Palivizumab in the first year of life; 86 (60.6%) children did not get sick in the second year of life; and 71 (47.3%) children received a complete prophylaxis regimen in the second year of life. It is concluded that as children became sick, they were more vaccinated, and hospitalization was a determining factor for the increase in adherence to prophylaxis with Palivizumab.