A survey on criteria for intubation in moderate to late preterm infants with respiratory distress

Abstract Background Respiratory distress syndrome (RDS) is one of the leading causes of early neonatal morbidity and mortality in late preterm infants (LPIs) worldwide. This matched cohort study aimed to assess how the antenatal dexamethasone use affect the respiratory distress (RD) proportion in preterm newborns between 34 0/7 weeks and 36 6/7 weeks of gestation. Methods This was a prospective cohort study on 78 women with singleton pregnancy who were in threatened preterm birth and had not received prior dexamethasone, who were admitted between 34 0/7 weeks and 36 6/7 weeks at Hue University of Medicine and Pharmacy Hospital from June 2018 to May 2020. The matched control group without dexamethasone use included 78 pregnant women diagnosed with threatened late preterm births who were at similar gestational ages and estimated fetal weights as the treatment group. The treatment group received 6 mg intramuscular dexamethasone every 12 h for a total of 4 doses or until delivery. Primary outcome was the rate of neonatal RD. Secondary neonatal outcomes included the need for respiratory support, neonatal intensive care unit (NICU) admission, hypoglycemia, necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death. Statistical analyses were performed by using SPSS software, version 26.0. Results The proportion of RD in LPI was significantly lower in the treatment group than in the matched control group (10.3% vs. 23.1%, respectively), adjusted Odds Ratio [aOR] 0.29; 95% confidence interval [CI] 0.10 – 0.83 and p = 0.021. Neonatal hypoglycemia was more common in the dexamethasone group than in the matched group (25.6% vs. 12.8%, respectively; aOR, 2.59; 95% CI, 1.06 – 6.33; p = 0.037). There were no significant between-groups differences in the incidence of respiratory support, NICU admission or length of hospital stay. Conclusions Administration of antenatal dexamethasone to women at risk for late preterm birth could help to lower the proportion of respiratory distress in late preterm infants.

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Effect of Antenatal Dexamethasone on Respiratory Distress in Late Preterm Infants: Results from the First Vietnamese Matched Cohort Study

10.21203/rs.3.rs-146925/v1 ◽

2021 ◽

Author(s):

Tran Tuan Hung Ho ◽

Quang Vinh Truong ◽

Thi Kim Anh Nguyen ◽

Minh Tam Le ◽

Vu Quoc Huy Nguyen

Keyword(s):

Cohort Study ◽

Treatment Group ◽

Respiratory Distress ◽

Preterm Infants ◽

Matched Control ◽

Late Preterm ◽

Control Group ◽

Matched Control Group ◽

Late Preterm Infants ◽

Nicu Admission

Abstract BackgroundRespiratory distress (RD) is one of the leading causes of early neonatal morbidity and mortality in late preterm infants (LPIs) worldwide. This study aimed to evaluate the effect of antenatal dexamethasone on the RD rate in preterm newborns between 34 0/7 weeks and 36 6/7 weeks of gestation.MethodsThis was a prospective cohort study of 78 women with singleton pregnancy who were in threatened preterm birth and had not received prior dexamethasone who were admitted between 34 0/7 weeks and 36 6/7 weeks at Hue University of Medicine and Pharmacy Hospital from June 2018 to May 2020. The matched control group (no dexamethasone) included 78 pregnant women with threatened late preterm births who were at similar gestational ages and estimated fetal weights as the treatment group. The treatment group received 6 mg intramuscular dexamethasone every 12 hours for a total of 4 doses or until delivery. Primary outcome was the rate of neonatal RD. Secondary neonatal outcomes included the need for respiratory support, neonatal intensive care unit (NICU) admission, hypoglycemia, necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death. Statistical analyses were performed by using SPSS software.ResultsThe rate of RD in LPI was significantly lower in the treatment group than in the matched control group (10.3% vs. 23.1%, respectively), with relative risk [RR] 0.44; 95% confidence interval [CI] 0.21 – 0.96 and p = 0.03. Neonatal hypoglycemia was more common in the dexamethasone group than in the matched group (25.6% vs. 12.8%, respectively; RR, 2.00; 95% CI, 1.00 – 3.99; p = 0.04). There were no significant between-group differences in the incidence of respiratory support, NICU admission or length of hospital stay.ConclusionsAdministration of antenatal dexamethasone to women at risk for late preterm birth could significantly reduce the rate of respiratory distress in late preterm infants.

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Surfactant Treatment of Late Preterm Infants during Emergency Transport: A Retrospective, Observational Study

Neonatology ◽

10.1159/000518986 ◽

2021 ◽

pp. 1-7

Author(s):

Francesco Cavallin ◽

Giorgia Carlone ◽

Nicoletta Doglioni ◽

Paolo Ernesto Villani ◽

Luca Vecchiato ◽

...

Keyword(s):

Confidence Interval ◽

Respiratory Distress ◽

Preterm Infants ◽

Outcome Measures ◽

Late Preterm ◽

Stabilization Time ◽

Late Preterm Infants ◽

Transport Team ◽

Emergency Transport ◽

Surfactant Administration

Background: In late preterm infants born in nontertiary hospitals, the occurrence of respiratory distress syndrome requires postnatal transport. This study aimed to investigate the impact of the timing of surfactant administration in late preterm infants needing postnatal transport. Methods: This is a retrospective study evaluating surfactant administration in late preterm infants during emergency transports by the Eastern Veneto Neonatal Emergency Transport Service between January 2005 and December 2019. The outcome measures included short-term clinical complications, stabilization time, oxygen concentration, duration of mechanical ventilation and noninvasive respiratory support, length of hospital stay, bronchopulmonary dysplasia, intraventricular hemorrhage, and sepsis. Results: Surfactant was administered to 155/303 neonates (51.1%) at 3 different time points: at a referring hospital (50 neonates), when the transport team arrived (25 neonates), or at a referral hospital (80 neonates). Stabilization time was longer in neonates receiving surfactant by the transport team (adjusted mean difference 17 min, 95% confidence interval, 4–29 min; p = 0.01). Decrease in oxygen concentrations during the transport was larger in neonates receiving surfactant at a referring hospital (adjusted mean difference −11%, 95% confidence interval, −15 to −3%; p = 0.01). The other outcome measures were not statistically different according to the timing of surfactant administration. Conclusions: In late preterm infants with respiratory distress needing postnatal transfer, stabilization time was longer when the first surfactant was administered by the transport team, but such delay did not affect safety and clinical outcomes.

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