Article

Incidência de hidrocefalia congênita e o papel do diagnóstico pré-natal

Jornal de Pediatria (Impact Factor: 1.19). 04/2003; 79(2). DOI: 10.1590/S0021-75572003000200008
Source: DOAJ

ABSTRACT

OBJETIVO: analisar criticamente o aumento da incidência de hidrocefalia na Maternidade do CAISM - UNICAMP, identificando o(s) fator(es) que podem explicar esse aumento. CASUÍSTICA E MÉTODOS: estudou-se os portadores de hidrocefalia nascidos no CAISM, no período de setembro de 1987 a dezembro de 1998, exceto as hidrocefalias secundárias a defeito de fechamento de tubo neural. Os dados foram coletados a partir dos arquivos do Programa de Genética Perinatal-CAISM, incluindo as fichas ECLAMC e as do Ambulatório de Genética Perinatal, além de prontuários médicos hospitalares dos recém-nascidos e/ou de suas mães. As hidrocefalias foram classificadas em quatro grupos clinicamente distintos. As incidências das hidrocefalias e suas tendências foram estudadas a partir do teste de tendência de Cochran-Armitage. RESULTADOS: foram registrados 111 recém-nascidos portadores de hidrocefalia (3,16/1.000 nascimentos). A incidência anual das hidrocefalias mostra uma tendência em aumento significativa (p = 0,001), que se acentuou após 1992. Dos 4 subgrupos de hidrocefalias (isoladas, associadas a infecção, associadas a síndromes dismórficas e associadas a defeitos múltiplos), apenas entre as isoladas foi observada tendência em aumento significativa (p = 0,001). A maioria, 85% (94/111), das hidrocefalias registradas no período tinha diagnóstico pré-natal, e dessas, em 66% identificou-se um encaminhamento para o CAISM devido a tal diagnóstico. CONCLUSÕES: o presente estudo sugere fortemente que a tendência em aumento das hidrocefalias no CAISM está associada ao diagnóstico ultra-sonográfico pré-natal e conseqüente encaminhamento preferencial desses casos para o CAISM, dada a sua condição de hospital de referência na região. Dentre os grupos clínicos de hidrocefalia, a tendência em aumento se verifica especialmente no grupo, etiologicamente heterogêneo, das hidrocefalias isoladas.

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