Avaliação da assistência e da saúde do recém-nascido de alto risco no Distrito Sanitário Leste de Belo Horizonte, 2006-2009

Abstract

This study assessed the health care process and health status of high-risk babies - birth weight less than or equal to 2000 grams and / or Apgar score under 7 at 5 minutes of life - born in 2006 and residents at the East Sanitary District of Belo Horizonte, according to health markers proposed by the City Health Department in the Follow-up guide for high-risk newborns. This is a cross-sectional study that used the health evaluation and action-research methods, aggregating the participation of health professionals and managers to acknowledge the problem and propose solutions to improve heath care. Sixty five children (62.5%) out of the 104 eligible population identified in Information System on Live Births (SINASC) 2006 were evaluated in their third year of life, using parents interview, clinical and developmental assessment. About 70% of the children were born in Unified Health System (SUS) hospitals, 33.3% lived at areas of high social vulnerability, 84.6% were preterm, 87.7% weighted less than or equal to 2000 grams,15.4% had Apgar scores of life under seven in the fifth minute and 15,4% had congenital malformation. Many mothers (33.3%) were at the extremes of age, had an unplanned pregnancy (60%) and an inadequate prenatal care (13.9%). These children presented health problems such as respiratory diseases (49.2%), especially asthma and delayed psychomotor development (16.9%). Many children were not monitored under the Follow-up guide for high-risk newborns at the Primary Health Centers (51%) and did not followed the recommended screenings to detect hearing (35,4%) and visual (60%) impairments, anemia (34,6%) and osteopenia (33,3%). It was also detected an inappropriate use of vitamin and ferric supplementation and special vaccines. The high-risk newborns still have little visibility on the primary health care, despite their higher risk of morbimortality as well as growth and development impairment. This study may support the implementation of public health surveillance and assistance to the high-risk newborn in Belo Horizonte, and help to provide improvements in their quality of life.