Clinico-etiological profile of respiratory distress in the new-born and its out-come

Abstract

Objectives: The objectives of the study are to estimate the incidence of respiratory distress (RD) with etiology and associated risk factors in newborns admitted to neonatal intensive care units and to propose adequate management plan for better clinical outcome. Study Design: This was a hospital-based prospective, longitudinal study. Setting: The study was conducted in a tertiary care teaching hospital of Odisha between November 2015 and October 2017. Study Population: A total of 202 newborns, born with RD, constitute the study population. The risk factors are delineated with outcome. Results: Out of 202 newborns with RD, 107 (53%) were males and 95 (47%) were females. Based on birth weight and gestational age, 35% were of very low birth weight (< 2000 grams; VLBW) and 19.8% were of low birth weight (2000 to <2500 grams; LBW). Both these groups accounted for 54.9% of all babies under the study. Pre-terms were 50.5% among VLBW and 9.9% among normal birth weight (NBW) babies. Most common etiology was found to be RD syndrome (RDS, 39.6%). 95% of cases survived while 5% resulted in death. 60% of the death was contributed by RDS and prematurity, while 40% of deaths were seen in term gestation with NBW resulting from birth asphyxia in this study. Although the death ratios in each group of newborns VLBW, LBW, and NBW were almost equal, the etiology of RD and death in the respective groups was different. Conclusion: The study shows an association between mortality and onset of RD. Early onset of RD increases mortality. Antenatal steroid administration has a positive outcome. VLBW and LBW newborns succumb more to RD. The etiology of RD is different in different categories of birth weight. Continuous positive airway pressure is the cornerstone in management of RDS.