scholarly journals Clinico-epidemiological study of respiratory distress in newborn and associated risk factors

2018 ◽  
Vol 5 (4) ◽  
pp. 1576
Author(s):  
Rishi Sodawat ◽  
Pukhraj Garg ◽  
Chaturbhuj Singh ◽  
Priyanka Sharma

Background: Respiratory distress (RD) is one of the most common causes of admission in neonatal intensive care unit (NICU) for a variety of pulmonary and non-pulmonary disorders. This study has been undertaken to evaluate prevalence of the known causes and risk factors associated with development of respiratory distress in neonates and finally to assess the clinical correlation with blood investigations, X-RAY, ECG, ABG and 2D ECHO.Methods: The present study was conducted in the department of Pediatrics at JLNMC Ajmer between February 2017 – February 2018, over a period of 12 months. It is a prospective case study.Results: Out of 600 newborns admitted with respiratory distress, Transient Tachypnea of Newborn (TTN) was found to be the most common cause (n = 196, 32.6%) followed by HMD (n = 145, 24.1%).Conclusions: Transient tachypnea of newborn is the most common cause among new-borns with respiratory distress. Majority of newborns develop severe distress within 6 hours after birth. In preterm and term babies the major cause of RD is Hyaline membrane disease (HMD) and HIE/CHD (hypoxic enchephalopathy/congenital heart disease) respectively. While in post term babies MAS is major cause of RD. Newborns with low and very low birth weight are more prone for development of severe distress.

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 663-668 ◽  
Author(s):  
Robert A. Parker ◽  
Daniel P. Lindstrom ◽  
Robert B. Cotton

The incidence of bronchopulmonary dysplasia (BPD) increased from 10.6% in 1976 through 1980, to 21.7% (1981 through 1985), and to 32.9% (1986 through 1990) in very low birth weight neonates (1500 g or less) admitted to the Vanderbilt Neonatal Intensive Care Unit, while there was a concurrent decline in incidence of neonatal death (NEOD) during the same periods (26.4%, 18.3%, and 15.9%, respectively). Population changes in risk factors (birth weight, sex, race, location of birth, gestational age, diagnosis of hyaline membrane disease, and 5-minute Apgar score) over time do not account for this increase. To estimate the proportion of the increase in BPD attributable to the concurrent decline in NEOD during these periods, separate logistic regression models for NEOD and BPD were calculated from patients born during 1976 through 1985. These results were used to predict the expected number of cases of NEOD and BPD during 1986 through 1990, assuming that the adjusted incidence of NEOD and BPD remained constant from 1976 through 1985, to 1986 through 1990. The increase in the combined outcome, NEOD/BPD, over the three time periods (34.2%, 36.1%, and 43.5%) remained statistically significant after adjustment for the risk factors listed above. During 1986 through 1990, the predicted number of NEOD was 83 more than the number observed, while the predicted number with BPD was 115 less than the number observed. If all 83 averted cases of NEOD during 1986 through 1990 had developed BPD, then 83 (72%) of the 115 excess cases of BPD could be attributed to averted NEOD. The approximate 95% confidence interval for this estimate was 58% to 87%. These results indicate that while most of the excess cases of BPD in 1986 through 1990 could be explained by neonates who previously would have died, there were still additional cases of BPD that were not explained by the risk factors included in this analysis.


2018 ◽  
Vol 16 (2) ◽  
pp. 131-135
Author(s):  
Prashant Rijal ◽  
Mandira Shrestha

Background: Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit. However, studies of newborn admitted with respiratory distress in our setup are limited. This study aims to look for incidence of neonatal respiratory distress in our setup, to analyze the common causes of respiratory distress and to determine possible strategic plan needed for better clinical outcome.Methods: A cross sectional study was conducted from March 2013 to December 2014 in Nepal Medical College and Teaching Hospital. Data of all the neonates with respiratory distress admitted during this period were analyzed.Results: Total 317 (13.4%) neonates were admitted to Neonatal Intensive Care Unit during the study period.109 neonates developed respiratory distress comprising 34.3% of all Neonatal Intensive Care Unit admissions. Incidence of neonatal respiratory distress was 4.6%. The common causes of respiratory distress in our study were meconium aspiration syndrome in 21.1%, septicemia in 16.5%, transient tachypnea of newborn in 15.5%, pneumonia in 14.6%, birth asphyxia and hyaline membrane disease were in each 11.9% of the neonates. Caesarean section was the most common predisposing factor associated with the development of transient tachypnea of newborn in 82.3% newborns (p=.001). The overall mortality rate due to respiratory distress was 12.8%.Conclusions: Meconium aspiration syndrome, septicemia and hyaline membrane disease are the most important causes of respiratory distress in our setup. Good obstetric care, proper training of health care personnel in neonatal resuscitation and early recognition of potential risk factors of respiratory distress will be helpful. 


Author(s):  
Munera Awad Radwan ◽  
Najia Abdelati El-Mansori ◽  
Mufeda Ali Elfergani ◽  
Mohanad Abdulhadi Lawgali

Background: Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS) is the most common lung condition affecting premature babies. The inadequate amount of surfactant causes alveoli to collapse when the baby breathes out. It is hard for your baby to re-inflate the collapsed alveoli when he breathes. The lack of surfactant and resulting inflammation is called. Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS). Aim of the Study: To determine the magnitude of Hyaline membrane disease or respiratory distress syndrome and identify the risk factors and complication among newborn babies in neonatal intensive care unit at Benghazi medical center (BMC). Materials and Methods: Case series study. The study was conducted during the period between March 2017 to March 2018 of HMD cases at Benghazi medical center. A convenient sample of 120 cases diagnosed as HMD. Studied variables include the following; gestational age, birth weight, gender, type of pregnancy and type of delivery also the data for mothers such as (diabetes mellitus, preeclampsia hypothyroidism, receiving of Dexamethasone injection and premature rupture of membrane). Also investigation and treatment and finally the outcomes of babies. Statistical Methods: Data were analyzed with SPSS version 17, analysis of associations was made with application Chi - square test for categorical variables comparison, was applied for test of association P <0.25. P was considered statistically significant if ≤ 0.05. Results: Female gender was predominant (52%). Most of cases of HMD were between 1000 -2000 kg. Among the 120 cases we have (15%) sever HMD and the majority of cases have moderate –to sever Hyaline membrane disease 39 (32.5%) whereas very sever HMD were observed in nearly 27% of cases. The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis, all these were found to be very common risk factors of HMD. Pearson chi-square test p value highly significant of female gender with complications of HMD. Our results observed more than half of babies were died. Conclusion: The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis all these were found to be very common risk factors of HMD. Also we concluded that the cases had premature rupture of membrane, which identified as risk factors of hyaline membrane disease. Furthermore, we concluded that highly significant of female gender with complications of HMD, such as Pneumothorax, bronco pulmonary, dysplasia, intra ventricular hemorrhage and congenital heart diseases were common co- morbidities with respiratory distress syndrome, all these could be have an association with the development of hyaline membrane disease, finally we observed more than half of babies were died this is a warning sign for health services.


2019 ◽  
Vol 60 (5) ◽  
pp. e357-e366 ◽  
Author(s):  
Javier de la Fuente ◽  
Dario Moreno-Agostino ◽  
Alejandro de la Torre-Luque ◽  
A Matthew Prina ◽  
Josep María Haro ◽  
...  

Abstract Background and Objectives There is a link between sensory and cognitive functioning across old age. However, there are no integrative measures for assessing common determinants of sensory-cognitive functioning. This study aims to develop a combined measure of sensory-cognitive functioning, and to identify heterogeneous trajectories and associated risk factors. Research Design and Methods Two thousand two hundred and fifty-five individuals aged 60 years and over selected from the first six waves (2002–2012) of the English Longitudinal Study of Ageing completed a set of five self-reported visual and hearing functioning items and four cognitive items. Several health-related outcomes were also collected. Results The common cause model presented longitudinal factorial invariance (Tucker-Lewis index [TLI] = 0.989; Comparative Fit Index [CFI] = 0.991; Root Mean Square Error of Approximation [RMSEA] = 0.026). A common factor explained 32%, 36%, and 26% of the visual, hearing, and cognitive difficulties, respectively. The developed sensory-cognitive measure predicted incident dementia over 10 years (area under the curve = .80; 95% confidence interval [CI] = .75, .86). A three-trajectory model was proved to fit better, according to growth mixture modeling. Low levels of education and household wealth, disability, diabetes, high blood pressure, depressive symptoms, and low levels of physical activity were risk factors associated with the classes showing trajectories with a steeper increase of sensory-cognitive difficulties. Discussion and Implications A time-invariant factor explains both sensory and cognitive functioning over 8 years. The sensory-cognitive measure derived from this factor showed a good performance for predicting dementia 10 years later. Several easily identifiable socioeconomic and health-related risk factors could be used as early markers of subsequent sensory-cognitive decline. Therefore, the proposed latent measure could be useful as a cost-effective indicator of sensory-cognitive functioning.


1999 ◽  
Vol 54 (5) ◽  
pp. 151-154 ◽  
Author(s):  
Monique Catache Mancini ◽  
Naila Elias Barbosa ◽  
Débora Banwart ◽  
Sandra Silveira ◽  
José Luiz Guerpelli ◽  
...  

Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0.035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0.02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.


2017 ◽  
Vol 4 (6) ◽  
pp. 2027
Author(s):  
Pushpak H. Palod ◽  
Bhagwat B. Lawate ◽  
Mahesh N. Sonar ◽  
Sneha P. Bajaj

Background: Respiratory disorders are the most frequent cause of admission for neonatal intensive care in both term and preterm infants. The clinical diagnosis of respiratory distress in a newborn is suspected if the respiratory rate is greater than 60 per minute in a quite resting baby, presence of grunting and/or there are inspiratory subcostal/intracostal retractions Signs and symptoms of respiratory distress include cyanosis, grunting, nasal flaring, retractions, tachypnea, decreased breath sounds with or without rales and/or rhonchi, and pallor. Objectives of present study were to know the clinical profile and aetiology of neonates with respiratory distress and to study the morbidity and mortality of respiratory distress in neonatal intensive care unit (NICU). And to find out the predictors of survival in the neonates admitted with respiratory distress.Methods: Study is done on 281 neonates admitted in Neonatal Intensive Care Unit (NICU) as a Prospective Cohort and Descriptive Study and Simple Random sampling is used to include neonates in the study. All the neonates included in study were subjected to the following detailed perinatal history and thorough clinical examination of newborns was done.Results: Males outnumber the females in admission. Most of the affected neonates were weighing between 1500g to 2500g (185). Out of total patients of two hundred and eighty-one, there were 35 deaths (12.5%) and 246 patients survived (87.5%). In present study most common causes for respiratory distress were respiratory distress syndrome (31.3%), neonatal septicaemia including pneumonia (28.1%), TTBN (16.7%).Conclusions: The overall survival rate was 87.5%. Male outnumber female on admissions but the survival in females was better than males. Common causes of respiratory distress in our study are RDS, Neonatal septicaemia and TTBN. As the gestation increased the survival also improved. Term neonates had better survival as compared to preterm neonates. Antenatal corticosteroid administration improved the survival. 


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