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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(01): 20-24
DOI: 10.1590/0004-282X20160184
Article

The mortality rate after hospital discharge in patients with myelomeningocele decreased after implementation of mandatory flour fortification with folic acid

Redução da taxa de mortalidade após a alta hospitalar em pacientes com mielomeningocele depois da implementação da fortificação obrigatória das farinhas com ácido fólico
Renato Manganelli Salomão
1   Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro RJ, Brasil
,
Tatiana Protzenko Cervante
2   Fundação Oswaldo Cruz (IFF/ Fiocruz), Departamento de Cirurgia Pediátrica, Setor de Neurocirurgia do Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Rio de Janeiro RJ, Brasil
,
José Francisco Manganelli Salomão
2   Fundação Oswaldo Cruz (IFF/ Fiocruz), Departamento de Cirurgia Pediátrica, Setor de Neurocirurgia do Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Rio de Janeiro RJ, Brasil
,
Soniza Vieira Alves Leon
3   Universidade Federal do Estado do Rio de Janeiro, Departamento de Neurologia, Rio de Janeiro RJ, Brasil
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ABSTRACT

Objective:

To evaluate the mandatory folic acid fortification of flour on mortality rates after the hospital discharge of children born with myelomeningocele, the most affected age group and the most frequent cause of death.

Methods:

A retrospective study of 383 children born with myelomeningocele from January 1990 to December 2013 in a high-fetal-risk reference hospital.

Results:

A total of 39 patients died (10.1%),of which 23 (6%) died after discharge. Most children who died were younger than 12 months of age. The most frequent cause of death was infection of the central nervous system, followed by urinary tract sepsis and infections of the respiratory system. Symptomatic Chiari II malformation was the most frequent comorbidity factor.

Conclusion:

Although there was no significant difference in infant mortality before and after folic acid fortification, there was a significant reduction in deaths after hospital discharge in babies born after implementation of mandatory folic acid fortification

RESUMO

Objetivo:

Avaliar a fortificação obrigatória de farinhas com ácido fólico nas taxas de mortalidade após a alta hospitalar de crianças nascidas com mielomeningocele, a faixa etária mais atingida e a causa mais freqüente de morte.

Métodos:

Estudo retrospectivo de 383 crianças nascidas com mielomeningocele de janeiro de 1990 a dezembro de 2013, em um hospital de referência de alto risco fetal.

Resultados:

Um total de 39 pacientes morreram (10,1%), dos quais 23 (6%) morreram após a alta. A maioria das crianças que morreram não alcançaram 12 meses de idade. A causa mais frequente de morte foi infecção do sistema nervoso central, seguido por sépsis, infecções do trato urinário e do sistema respiratório. A malformação de Chiari Tipo II foi a comorbidade mais freqüente.

Conclusão:

Apesar de não haver diferença significativa na frequência de mortalidade de recém-nascidos, antes e depois da fortificação obrigatória com ácido fólico, houve uma redução significativa no número de mortes após a alta hospitalar em bebês nascidos após a implementação da fortificação obrigatória das farinhas com ácido fólico.

Keywords:

meningomyelocele - mortality - folic acid

Palavras-chave:

meningomielocele - mortalidade - ácido fólico


Publication History

Received: 17 December 2015

Accepted: 28 September 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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