DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20162364

Clinical study of respiratory distress in newborn

Rajavarapu Chandrasekhar, Manchu Madan Mohan, B. Vijaya Lakshmi

Abstract


Background: Respiratory distress in neonates is the most common cause of admission to a neonatal ICU in a tertiary care hospital. Identification of risk factors associated with development of severe distress and early diagnosis of cause is very important in the management of neonatal distress for better clinical outcome.

Methods: 100 consecutive born neonates with respiratory distress were studied and assessed for development of severe distress against onset, duration, oxygen requirement and outcome in terms of final diagnosis, mortality and treatment interventions. Serial chest X- rays were done at 1 hour and 6 hours of onset of distress to identify abnormal findings. Association of multi variable risk factors both maternal and neonatal was studied for development of severe respiratory distress.

Results: Transient tachypnoea of newborn (60%) was the commonest cause of newborn respiratory distress. Development of severe distress was more when onset is at 6 hours after birth (77%), duration persists more than 24 hours (65.5%) Oxygen requirement in number of days increases depending on diagnosis TTNB 100% for <1 day, MAS 95.4% for 2 days and RDS 100% for 3 days. Ventilation was done in 3 cases and there was no mortality.

Conclusions: Transient tachypnea of the newborn is the most common cause of respiratory distress in newborn. Almost 50% of newborn with respiratory distress develop severe respiratory distress which require intensive monitoring. Risk factors like high maternal age, primigravida mothers, more than 4 per vaginal examinations, meconium stained liquor, cesarean delivered newborns, Small for gestation age, and 1 min Apgar score less than 7, birth weight less than 2.5Kg and male sex of newborn were associated with severe respiratory distress in newborns.


Keywords


Respiratory distress, New-born, Risk factors, Chest x rays, Oxygen requirement

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References


NNF Recommended Basic Perinatal-Neonatal Nomenclature. In: DK Guha, editors. Neonatology- Principles and Practice. 1st ed. New Delhi: Jaypee Brothers. 1998:131-2.

Khatua SP, Gangwal A, Basu P, Patodhi PKR. The incidence and etiology of respiratory distress in newborn. Indian Pediatr. 1979;16:1121-6.

Gouyon JB, Ribakovsky C, Ferdynus C, Quantin C, Sagot P, Gouyon B, et al. Severe respiratory disorders in term neonates. Paediatric and Perinatal Epidemiology. Paediatr Perinat Epidemiol. 2008;22(1):22-30.

Kumar A, Bhat BV. Epidimeology of respiratory distress in newborn. Indian J Pediatr. 1996;63:93-8.

Rygal M. Neonatal respiratory distress syndrome: anautopsy study of 190 cases. Indian J Pediatr. 1985:52:43-6.

Angus DC, Linde-Zwirble WT, Clermont G. Epidemiology of Neonatal Respiratory Failure in the United States. Am J Respir Crit Care Med. 2011;164:1154-60.

Escobar GJ, Clark RH, Greene JD. Outcomes of Infants Born at 35 and 36 Weeks Gestation. Semin Neonatol. 2000;5:89-106.

Dani C, Reali MF, Bertini G, Wiechmann L. Risk factors for the development of respiratory distress,syndrome and transient tachypnoea in newborn infants. Eur Respir J. 1999;14:155-9.

Mathur NB, Garg K. Respiratory distress in newborn. Indian pediatrics. 2002;39:527-9.

Geller EJ, Wu JM, Jannelli ML, Nguyen TV. Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery. Journal of Perinatology. 2010;30:258-64.

Kwang-sun L, Eidelman AI, Po-I T, Kandail SR. Lawrence Respiratory Distress Syndrome of the Newborn and Complications of Pregnancy. Pediatrics. 1976;58:675-80.

Lureti M. Risk factors for respiratory distress syndrome in the newborn: A multicenter Italian survey.Acta Obstetricia et Gynecologica Scandinavica. 1993;72(5):359-64.

Miller HC. Respiratory Distress Syndrome of Newborn Infants: Statistical Evaluation of Factors Possibly Affecting Survival of Premature Infants Pediatrics. 1998:573-579.