OUTCOME OF PRETERM BABIES WITH RESPIRATORY DISTRESS SYNDROME

Background: To study outcome of preterm babies with RDS in babies admitted in NICU. Methods: This study was hospital based prospective study of preterm neonates with respiratory distress syndrome admitted in NICU of MBGH RNT medical college Udaipur, from February 2017 to January 2018. Results: Among 200 preterm neonates included in the study 31 neonates expired. Mortality was 15.5%. The mortality was 10.17% among the preterm neonates with RDS and hospitalized within 6 hrs. It was 31.81% among neonates hospitalized between 6-12 hrs and 62.5% and 66.66% among neonates hospitalized between 12-24 hrs and after 24 hrs of birth respectively. Conclusion: Mortality rate is inversely related to birth weight and gestational age and directly related to age at admission and severity of respiratory distress (Silverman-Anderson score). Keywords: Preterm, Neonates, Birth weight.

Download Full-text

Competing Risk Analysis of the Health Status of Neonates with Respiratory Distress Syndrome

Journal of Biostatistics and Epidemiology ◽

10.18502/jbe.v6i2.4878 ◽

2020 ◽

Author(s):

Zenaw Ayele ◽

Mekonnen Tadesse ◽

Zelalem Tazu

Keyword(s):

Prognostic Factors ◽

Birth Weight ◽

Health Status ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Preterm Infants ◽

Gestational Age ◽

Distress Syndrome ◽

Competing Risk

Introduction: Respiratory distress syndrome (RDS) is not only the most common respiratory disorder in premature infants but also the main cause of neonatal mortality. Methods: Competing risk framework was used to examine and identify potential prognostic factors of the health status of preterm infants with respiratory distress syndrome. Preterm infants with RDS admitted to the neonatal intensive care units (NICUs) of selected hospitals in Ethiopia were followed for 28 days and only neonates with complete cases were included in the analysis. The Fine-Gray or sub-distribution hazard model was used to identify significant prognostic factors. Three outcome variables (death due to RDS, death due to other causes and discharged alive) were considered. Results: The Fine-Gray model fit results revealed that anemia, multiple pregnancies, birth-weight and gestational age were the prognostic factors significantly associated with the death of neonates due to Respiratory distress syndrome problem while Pneumonia, meningitis, anemia and gestational age of neonates were the significant prognostic factors for death of neonates due to other causes. Moreover, pneumonia, birth weight and gestational age were identified as the prognostic factors associated with neonates being discharged alive. Conclusion: Offering intensive and adequate treatments for neonates with lowest birth-weights and gestational age may be useful to reduce neonatal mortality and increase the incidence of being discharged alive.

Download Full-text

Study Of The Outcome Of Early And Late Rescue Surfactant Administration In Preterm Babies

Asian Journal of Health Sciences ◽

10.15419/ajhs.v2i2.408 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Jayachandra Naidu T ◽

Kireeti AS ◽

Lokesh B ◽

Shankar Reddy Dudala

Keyword(s):

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Surfactant Therapy ◽

Preterm Neonates ◽

P Value ◽

Surfactant Replacement Therapy ◽

Preterm Babies ◽

Surfactant Administration

Introduction: Respiratory Distress Syndrome (RDS) is a common cause of mortality and morbidity in preterm. It is the commonest indication for ventilation in neonates in India. Surfactant Replacement Therapy (SRT) for RDS is a major breakthrough that has revolutionized the survival of premature infants worldwide. Randomized controlled trials have also demonstrated that prophylactic or early surfactant therapy compared with delayed surfactant treatment results in improved outcomes for preterm infants at high risk. Objective: To assess the outcome of early and late rescue surfactant administration by InSuRE (Intubation, Surfactant and Rapid Extubation) technic in managing preterm neonates with respiratory distress syndrome (RDS). Methodology: Study design: Prospective analytical study. Sample size: 144 preterm babies between 28-34 weeks of GA. Setting: Level III NICU at SVRR Government General Hospital, Tirupati, AP. Study Period: 1 year (Sep 2013 to Aug 2014). Method: All preterm babies between 28-34 weeks with respiratory distress were given surfactant with InSuRE technic immediately and categorized into early and late rescue group depending on the time of surfactant therapy i.e. within 2 hrs. of life and between 2-24 hrs. of life respectively. Results: In early rescue group there is significant reduction in mortality and lessen the need of mechanical ventilation with p value <0.05. Conclusion: Early routine surfactant administration within 2 hrs. of life as compared to late selective administration significantly reduced the need mechanical ventilation within 7th day of life and mortality among preterm with respiratory distress syndrome.

Download Full-text

CONTROLLED TRIAL OF INTENSIVE CARE FOR VERY LOW BIRTH WEIGHT INFANTS

PEDIATRICS ◽

10.1542/peds.48.5.711 ◽

1971 ◽

Vol 48 (5) ◽

pp. 711-714

Author(s):

W. H. Kitchen ◽

D. G. Campbell

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Mortality Rate ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Very Low Birth Weight ◽

Controlled Trial ◽

Arterial Oxygen ◽

Low Birth Weight Infants

Two controlled clinical trials were carried out in infants with a birth weight between 1,000 and 1,500 gm. Careful control of arterial oxygen and the infusion of 10% glucose for the first 3 days of life failed to reduce the mortality rate in a group of 118 infants. In the second clinical trial involving 120 patients, the mortality rate was reduced, especially in infants with clinical evidence of respiratory distress syndrome, by the addition to the regime of early vigorous efforts to correct acidosis. The mortality in comparable infants before the introduction of intensive care in 1965 was 49%. In the era of intensive care, 35% of patients given only routine care died, whereas infants receiving vigorous intensive care had a mortality rate of only 18%. The patients with respiratory distress syndrome showed the most noticeable improvement in survival.

Download Full-text

A Comparison of Leak Synchronized Nasal SIMV Methods and Leak Compensated Nasal SIMV in Newborns with Respiratory Distress Syndrome

The Journal of Pediatric Academy ◽

10.51271/jpea-2021-0094 ◽

2021 ◽

pp. 18-21

Author(s):

Ahmet Özdemir ◽

Mustafa Ali Akın ◽

Osman Baştug ◽

Tamer Güneş

Keyword(s):

Blood Pressure ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Significant Difference

The aim of the present study was to compare the efficacy of leak compensated nasal SIMV (LCnSIMV) and leak synchronized nasal SIMV (LSnSIMV) modes in order to reduce the need for endotracheal intubation and associated complications in newborns with respiratory distress. This randomized, prospective study was conducted on 50 infants (25 per group) with gestational age below 34 weeks and/or below 2000 grams who have been admitted to NICU of Erciyes University Hospital because of respiratory distress syndrome (RDS) and need for mechanical ventilation. Infants with congenital heart disease, nasopharyngeal pathology (coanal atresia and cleft palate-lip) were excluded. Infants monitored on mechanical ventilator after surfactant were randomly assigned to LCnSIMV and LSnSIMV groups before extubation. SPO2/FiO2 (S/F), peak heart rate (PHR), respiration rate per minute (RRM), and arterial blood pressure (aBP) values of patients were recorded. Gestational age, birth weight, gender, RDS, patent ductus arteriosus (PDA) requiring treatment, presence of intraventricular bleeding (IVH), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) were recorded. The patients enrolled in the study were female by 48% and male by 52%. There was not any statistically significant difference between groups for gender, postnatal age and birth weight. There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for non-invasive ventilation period and re-intubation rate (p=0.04 and p=0.03, respectively). There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for SpO2 and S/F rates at 60 minutes (p=0.03 and p=0.01, respectively). There was not any difference between groups for blood pressure, PDA, IVH, ROP, BPD, NEC, sepsis and air leak. It may be appropriate to prefer the LSnSIMV method in patients with respiratory distress syndrome who need non-invasive ventilation in the pre-extubation period by considering the patient-ventilator compliance for positive effect in terms of mechanical clinical variables.

Download Full-text

Investigation Into the Current Situation and Analysis of the Factors Influencing Extrauterine Growth Retardation in Preterm Infants

Frontiers in Pediatrics ◽

10.3389/fped.2021.643387 ◽

2021 ◽

Vol 9 ◽

Author(s):

Ting Zhao ◽

Hui-Ming Feng ◽

Bayier Caicike ◽

Yan-Ping Zhu

Keyword(s):

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Preterm Infants ◽

Gestational Age ◽

Growth Retardation ◽

Distress Syndrome ◽

Factors Influencing ◽

Extrauterine Growth Retardation ◽

Growth Indicators

Objective: This study aims to explore the occurrence of extrauterine growth retardation (EUGR) in preterm infants with a gestational age of <34 weeks, at discharge, and the factors influencing the occurrence of EUGR.Method: A retrospective analysis of 691 preterm infants with a gestational age of less than 34 weeks, born in our hospital over the past 3 years. At discharge, the growth indicators head circumference, weight, and length were used to divide the infants into an EUGR group (n = 255) and the non-EUGR group (n = 436). The occurrence of EUGR and its influencing factors were then analyzed.Results: Of the 691 preterm infants evaluated for inclusion in the study, 255 cases (36.9%) met the requirements of EUGR at discharge. The different growth indicators used, i.e., weight, length, and head circumference, classified the infants differently. The incidence of EUGR using these measures was 30.2% (209), 27.9% (193), and 23.2% (161), respectively. The results of a univariate analysis showed that gestational age, birth weight, intrauterine growth retardation (IUGR), maternal gestational hypertension, age at which the infant commenced feeding, duration of the application of an invasive ventilator, length of hospital stay, nosocomial infection, respiratory and gastrointestinal diseases, symptomatic patent ductus arteriosus, and the early onset of neonatal sepsis were correlated with the occurrence of EUGR. Further logistic multivariate regression analysis revealed that low gestational age, low birth weight, complicated IUGR, respiratory distress syndrome, and necrotizing enterocolitis were independent risk factors for EUGR in preterm infants with a gestational age <34 weeks.Conclusion: In preterm infants with a gestational age <34 weeks in our hospital, there is a high incidence of EUGR, which is affected by factors such as the gestational age, birth weight, IUGR, respiratory distress syndrome, necrotizing enterocolitis, and other factors.

Download Full-text

Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy

10.21203/rs.3.rs-76613/v1 ◽

2020 ◽

Author(s):

Beatrice Olack ◽

Nicole Santos ◽

Mary Inziani ◽

Vincent Moshi ◽

Polycarp Oyoo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Distress Syndrome ◽

Neonatal Period ◽

Preterm Neonates ◽

Neonatal Deaths ◽

Social Autopsy

Abstract BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

Download Full-text

Follow-up Studies of Very Low Birth Weight Infants (1,250 Grams or Less) Born and Treated Within a Perinatal Center

PEDIATRICS ◽

10.1542/peds.66.3.438 ◽

1980 ◽

Vol 66 (3) ◽

pp. 438-444

Author(s):

Savitri P. Kumar ◽

Endla K. Anday ◽

Linda M. Sacks ◽

Rosalind V. Ting ◽

Maria Delivoria-Papadopoulos

Keyword(s):

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Small For Gestational Age ◽

Distress Syndrome ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Perinatal Center ◽

Appropriate For Gestational Age

The growth and development of inborn very low birth weight infants was evaluated in 50 of 60 survivors from 132 babies weighing ≤1,250 gm born July 1974 to December 1977. Mean ± SE birth weight and gestation was 1,066 ± 19.3 gm and 29.5 ± 0.3 weeks, respectively, with 13 infants small-for-gestational age. Of the survivors, 26% weighed ≤1,000 gm. Male to female ratio was 1:1.4. Apgar scores ≤5 at five minutes occurred in 16% of the infants. Respiratory distress syndrome occurred in 56%, but only 10% (5/50) required mechanical ventilation. At 1 year, 46% small for gestational age (SGA) and 8% appropriate for gestational age (AGA) infants were less than the third percentile for weight. Major neurologic abnormality occurred in three infants (6%), one of whom is also blind. Grade V retrolental fibroplasia occurred in two others. Severe developmental delay (development quotient <80, Gesell) occurred in these five infants and two other neurologically normal babies. Of 15 infants weighing ≤1,000 gm, two had major handicaps. Eight percent of the AGA infants and 30% of the SGA infants had major handicaps. These data indicate that infants born and treated in a perinatal center have a decreased incidence of asphyxia and severe respiratory distress syndrome and that the incidence of major handicaps is reduced, especially in the appropriate for gestational age baby.

Download Full-text

Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04012-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Beatrice Olack ◽

Nicole Santos ◽

Mary Inziani ◽

Vincent Moshi ◽

Polycarp Oyoo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Distress Syndrome ◽

Neonatal Period ◽

Preterm Neonates ◽

Neonatal Deaths ◽

Social Autopsy

Abstract Background Under-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study. Methods Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). Results Between January 2017 to December 2018, 3175 babies were born preterm or LBW, and 164 (5.1%) died in the first 28 days of life. VASA was conducted among 88 (53.7%) of the neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 h of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. Conclusion Deaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

Download Full-text