Abstract
BackgroundRespiratory distress syndrome (RDS), a consequence of lung immaturity, is a serious complication of preterm birth and the primary cause of early neonatal mortality. Administration of antenatal steroids is a standard care method for mothers with anticipated preterm labor. However, the gestational age range at which antenatal corticosteroids (ACS) provide benefit has been subjected to debate. This study aimed to find the prevalence of ACS use in patients that developed/did not develop RDS. MethodsThis cross-sectional study was conducted at Rafidia governmental surgical hospital. It is based on the data obtained from the files of mothers who gave birth to premature babies and from a face-to-face interview. One hundred and twenty-eight data collection forms were completed over a period of seven months. ResultsApproximately 64% of mothers, mothers who gave birth to premature babies, were given ACS, and about 33% of premature neonates developed RDS. Mothers who gave birth to newborns with RDS have lower odds of being administered ACS by 44% (OR = 0.44, CI = 0.202–0.94, p value = 0.034). However, the association became statistically not significant after adjusting gestational age, birth weight, gender, mother's age, intrauterine growth restriction (IUGR), mode of delivery and gestational hypertension (OR = 0.462, CI = 0.137–1.56, p value = 0.212). Higher risk of RDS was significantly associated with lower gestational age (p-value < 0.001) and IUGR after adjustment (p value = 0.035). However, no significant association could be found between RDS and mode of delivery (p value = 0.730), maternal age (p value = 0.63) and gender of the baby (p value = 0.22). Conclusionsthe overall prevalence of RDS in preterm infants was 33.3% and the identified risk factors were lower gestational age and IUGR. We showed that the administration of ACS wasn't significantly associated with the development of RDS after adjusting gestational age, birth weight, gender, mother's age, IUGR, mode of delivery and gestational hypertension, as the administration of ACS didn't fully meet the international guidelines.
Highlights
Premature birth has a significant long-term health effect because of increased risk of death and the development of a wide range of chronic physical and neurological disabilities compared with long-term birth [1, 2]
The main feature of Respiratory distress syndrome (RDS) is the inadequate production of surfactant in the lungs of preterm infants due to the immature development of type II pneumocytes beginning with the production of surfactants after about 20 weeks of gestation [7]
It may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status
Summary
Premature birth has a significant long-term health effect because of increased risk of death and the development of a wide range of chronic physical and neurological disabilities compared with long-term birth [1, 2]. The main feature of RDS is the inadequate production of surfactant in the lungs of preterm infants due to the immature development of type II pneumocytes beginning with the production of surfactants after about 20 weeks of gestation [7] Risk factors for this pathology include maternal age, birth weight, gestational age, elective care and emergency cesarean section (CS), gender, and prepartum asphyxia [8, 9, 10]. We showed that the administration of ACS wasn't significantly associated with the development of RDS after adjusting gestational age, birth weight, gender, mother's age, IUGR, mode of delivery and gestational hypertension, as the administration of ACS didn't fully meet the international guidelines
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