Maternal risk factors associated with the necessity of neonatal intensive care unit

PURPOSE: To evaluate the maternal risk factors that require newborn assistance in neonatal Intensive Care Units (ICU). METHODS: A prospective observational case-control study was conducted on 222 pregnant women (1: 1 case-control ratio) attended at a public maternity. The following variables were analyzed in the puerperae: age at menarche, age at first sexual intercourse, history of chronic diseases, habits, prenatal care, obstetric history, clinical complications during pregnancy and childbirth, and sociodemographic variables. The variables of the newborns were: Apgar scores, gestational age, birth weight, presence or absence of malformation, need for resuscitation, and complications during the first 24 hours. Proportions were compared using the Fisher exact test or the Person gamma(2) test. Multivariable models were developed by logistic regression analysis using adjusted Odds Ratio with a 95% confidence interval (CI). RESULTS: Regarding reproductive history, >= 3 pregnancies and 2 or 3 previous cesareans were sytatistically significant (p=0.0 and 0.0, respectively). Among the complications that required assistance in the neonatal ICU, prematurity was responsible for 61 cases (55.5%), followed by risk of intrapartum infection in 46 cases (41.8%). Regarding the maternal history, the presence of hypertensive disease showed statistical significance (p= 0.0). Premature rupture of membranes was strongly associated with the need for the neonatal ICU (Odds Ratio -OR= 6.1, 95% CI 2.6-14.4). CONCLUSIONS: Premature rupture of membranes and hypertensive disease should receive special attention in prenatal care due to their strong association with newborns requiring assistance in the neonatal ICU.