Publication:

Clinical study of respiratory distress in newborn

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.