Newborns with Respirtory Distress Syndrome in Lamphoon Hospital

Abstract

           Background: Respiratory distress syndrome (RDS) is the major cause of death in low birth weight newborns. In Lamphoon Hospital, RDS is an important cause of death in premature infants and is the leading cause of neonatal death. Objective: To explain the medical outcomes of newborn patients with RDS and the characteristics associated with death. Setting: Lamphoon Hospital. Design: Retrospective cohort study. Methods: Information were searched for from the medical records of newborn patients aged 0-28 days. Whose diagnosis was respiratory distress syndrome and were admitted in the pediatric intensive care unit or neonatal unit. Between October 1^st 2001 and September 30^th 2004. Data included maternal history of pregnancy. Labor, their complications and treatments, newborn clinical characteristics, treatments, complications and clinical outcomes. Data were described by descriptive statistics, the risk of death was analysed and presented with risk ratio (RR) and 95% confidence interval. Results: There were 82 newborn patients who were admitted with the diagnosis of RDS,56.1% were male and 43.9 % female. All subjects developed RDS within the first 24 hours after birth. The average birth weight was 1,707.5 grams (SD=524). Apgar score of 0-3 was observed in 3.9%. The gestational age by Ballard score was 32 weeks (SD=3.1). Appropriate growth for gestational age was observed in 86.6% and prematurity in 97.5%. Maternal complication was noted in 32.9%. Corticosteroid was not given to mothers with premature labor pain in 74.4%. Ventilation was required in 65.8% of the cases. Complications were reported in 39.1%, the most common ones were pneumonia. Sepsis and bronchopulmonary dysplasia. Case fatality was reported in 12.2%. The only characteristic that significantly increased the risk of death was asphyxia. Other non-statistically significant characteristics were low birth weight. Gestational age of less than 27 weeks, mothers not receiving corticosteroid while in premature labor pain. Or receiving but inadequate doses. Neonatal sepsis and pneumonia. Conclusion: RDS in newborn patients in Lamphoon Hospital were mainly caused by prematurity. Mothers whom corticosteroid were given while in premature labor were few in proportion. Case fatality was reported in 12.2%. The characteristic that increased the risk of death was asphyxia. Other possible risks were birth weight. Mothers not receiving corticosteroid while in premature labor pain. Or receiving but inadequate doses. Neonatal sepsis or pneumonia. More information will be needed to prevent both these antenatal and intrapartal risk factors. Including the complications observed in this group of newborn patients.