Treatment for neonatal respiratory distress syndrome in extremely low-birth weight premature infants: selection of respiratory support

Introduction. Respiratory distress syndrome (RDS) is characterized by immaturity of lung tissue, surfactant deficiency and is a common cause of mortality in premature infants. X-ray is the main method for determining the causes and severity of respiratory failure in newborns.Purpose. Systematization of the results of X-ray examination of the lungs of newborns with varying degrees of prematurity, compared with autopsy data.Materials and methods. The analysis of X-ray data and sectional material of 32 premature infants with low and extremely low body weight who died with clinical manifestations of RDS was performed.Research results. The article provides a comparative analysis of various types of radiological changes in the lungs (reticulo-nodular pulmonary pattern (n=10), cellular deformity of the pulmonary pattern (n=5), «air bronchogram» (n=20), «air leakage» syndrome (n=6), focal-confluent shadows/infiltrative-like foci of darkening (n=9)) and autopsy results of premature newborns.Conclusion. The greatest number of coincidences of radiological and histological data took place in BPD (80%), the smallest — in pulmonary hemorrhages (20%). The coincidence of conclusions for pneumonia and GM disease is 58–56%, respectively. Difficulty in the differential diagnosis of the X-ray picture of the lungs in low birth-weight infants lies in the frequent combination of pathological conditions. Respiratory failure with a wide range of pathological changes in the lungs developed in 15 (53,6%) newborns in the absence of criteria for surfactant insufficiency against the background of respiratory support.

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Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Scientific Reports ◽

10.1038/s41598-019-49561-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Yu-Hua Wen ◽

◽

Hwai-I. Yang ◽

Hung-Chieh Chou ◽

Chien-Yi Chen ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Very Low Birth Weight ◽

Neonatal Respiratory Distress Syndrome ◽

Low Birth Weight Infants ◽

Vlbw Infants ◽

Neonatal Respiratory Distress

Abstract Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997–2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.3%) infants born to preeclamptic mothers. The mean (standard deviation) gestational ages were 30.7 (2.5) weeks in the preeclamptic group and 28.6 (2.9) weeks in the control (non-preeclamptic) group. Severe RDS was defined according to the surfactant therapy requirement. The incidence of severe RDS was lower in infants exposed to maternal preeclampsia than in controls [28.9% vs. 44%; odds ratio (OR), 0.52; 95% confidence interval (CI), 0.47–0.57]. However, after adjustment for confounders, the OR for severe RDS development in the preeclampsia group was 1.16 (95% CI, 1.02–1.31). Other factors, such as gestational age, birth weight, female sex, and antenatal receipt of two or more steroid doses were significantly protective against RDS in multivariate regression analysis. This study revealed that maternal preeclampsia slightly increases the risk of severe RDS in VLBW infants.

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