Respiratory Distress Syndrome in a tertiary centre over ten year period - A descriptive study
Abstract
Background- Respiratory distress syndrome (RDS) is a common cause of neonatal morbidity and mortality in preterm infants.
Objective- To determine the demographics of babies admitted with RDS, their perinatal risk factors, short term outcomes and need for surfactant.
Material and Methods- All admitted babies in the neonatal unit between 1st January 2007 and 31st December 2016 who were diagnosed as RDS were included.
Result- Out of 79721 babies 400 babies were diagnosed as RDS (Incidence 4.13/1000 live births) and 390 RDS babies were included in analysis after excluding 10 babies for inadequate data. The median gestational age was 31 weeks, birth weight 1380 gram with male:female ratio of 1.6:1. Pregnancy induced hypertension (PIH) was the commonest associated perinatal factor (36%). Almost 53% of mothers received antenatal steroids. Sixty percent of babies were managed with continuous positive airway pressure (CPAP) alone, 26% required conventional ventilation following CPAP failure and 5% required high frequency ventilation. One third of newborn with RDS received surfactant. Adverse clinical outcomes were significantly more in surfactant group compared to those who did not receive surfactant, such as patent ductus arteriosus (PDA) requiring treatment (35.2% vs. 22.4%; p .009), intraventricular hemorrhage (20.5% vs. 8.2%; p .001), sepsis (53.3% vs. 38.8%; p 0.006), chronic lung disease (8.2% vs. 2.6%; p .017) and death (23% vs. 8.6%; p.0001)
Conclusion- PIH was the commonest association in mothers of babies with RDS. Most of the babies were managed with noninvasive ventilation. Only one third babies required surfactant. Incidence of mortality and morbidities were significantly higher in patients receiving surfactant.
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