Sobrevida e morbidade em prematuros com menos de 32 semanas de gesta？？o na regi？o central do Brasil

purpose: to evaluate the survival and complications associated with prematurity of infants with less than 32 weeks of gestation. methods: it was done a prospective cohort study. all preterm infants with a gestational age between 25 and 31 weeks and 6 days, born alive without congenital anomalies and admitted to the nicu between august 1st, 2009 and october 31st, 2010 were included. newborns were stratified into three groups: g25, 25 to 27 weeks and 6 days; g28, 28 to 29 weeks and 6 days; g30, 30 to 31 weeks and 6 days, and they were followed up to 28 days. survival at 28 days and complications associated with prematurity were evaluated. data were analyzed statistically by c2 test, analysis of variance, kruskal-wallis test, odds ratio with confidence interval (ci) and multiple logistic regression, with significance set at 5%. results: the cohort comprised 198 preterm infants (g25=59, g28=43 and g30=96). the risk of death was significantly higher in g25 and g28 compared to g30 (rr=4.14, 95%ci 2.23-7.68 and rr=2.84, 95%ci: 1.41-5.74). survival was 52.5%, 67.4% and 88.5%, respectively. survival was greater than 50% in preterm >26 weeks and birth weight >700 g. neonatal morbidity was inversely proportional to gestational age, except for necrotizing enterocolitis and leukomalacia, which did not differ among groups. logistic regression showed that pulmonary hemorrhage (or=3.3, 95%ci 1.4-7.9) and respiratory distress syndrome (or=2.5, 95%ci 1.1-6.1) were independent risk factors for death. there was a predominance of severe hemorrhagic brain lesions in g25. conclusion: survival above 50% occurred in infants with a gestational age of more than 26 weeks and >700 g birth weight. pulmonary hemorrhage and respiratory distress syndrome were independent predictors of neonatal death. it is necessary to identify the best practices to improve the survival of extreme preterm infants.