Multicenter investigation and analysis of neonatal respiratory distress syndrome in parts of Inner Mongolia

Abstract

Objective To investigate the diagnosis and treatment status of neonatal respiratory distress syndrome (NRDS) in Inner Mongolia and explore the problems and countermeasures for NRDS diagnosis and treatment. Methods Data of infants with NRDS in 4 hospitals(3 hospitals were in the west, which were the Affiliated Hospital of Inner Mongolia Medical University, Baotou Steel Three Hospital and Ordos Central Hospital, 1 hospital was in the east, which was the Affiliated Hospital of Chifeng Institute) participating in the study during the period from 1th January, 2016 to 30th June, 2018 were investigated retrospectively with descriptive epidemiological survey, including basic situation, perinatal period, clinical manifestations, treatment, complications and prognosis. Results Among 11 406 newborns admitted in 4 hospitals during the study period, 748 infants were diagnosed with NRDS, accounting for 6.56%.In the eastern region, 279 infants were diagnosed with NRDS, the rate was 9.30%, and in the western region were 469(5.58%). The average hospitalization time in the eastern region was longer than that in the western region, and the age of mothers was higher than that in the western region.There were significant differences between the two groups(P<0.05). The antenatal hormone use, cesarean delivery, multiple gestation, low Apgar score, premature rupture of membrane in the western region were higher than those in the eastern region(P<0.05). The proportion of NRDS grade Ⅰ and gradeⅢ, pulmonary surfactant(PS) utilization ratio and INSURE technology usage in the eastern region were higher than those in the western region.The ratio of NRDS(grade Ⅱ) and the first dose of PS in the western region were higher than those in the eastern region(P<0.05). The total mortality of neonates with NRDS was 6.15%(46/748). The incidence rates of patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis, ventilator-associated pneumonia in the western region were higher than those in the eastern region(P<0.05). Conclusion The level of diagnosis and treatment of NRDS in four hospitals in two districts of Inner Mongolia varies widely.But overall compared with other areas, the treatment of NRDS in Inner Mongolia has the problems of low antenatal hormone use, insufficient use of PS and INSURE technology, and late use of PS.The treatment of NRDS should continue to standardize antenatal hormone use, early and sufficient use of PS, the promotion of the use of INSURE technology. Key words: Neonates; Respiratory distress syndrome; Epidemiology