Regional variation in practice and outcome of neonatal respiratory distress syndrome between the South-eastern and Mid-western China

Abstract

Objective To investigate and compare the status of admission and treatment of neonatal respiratory distress syndrome (RDS) in neonatal intensive care units (NICUs) between the South-eastern and Mid-western China. Methods Twenty-three NICUs of tertiary maternity and children's hospitals participated in the survey. Data of infants with RDS admitted to NICU of participated hospitals from Mar. 1, 2004 to Feb. 28, 2005 were collected. Infant information including demographics, ante-and perinatal history, respiratory care, survival and clinical burden were compared. Results Seven hundred and eleven infants with RDS accounted for 5. 4% of NICU admissions enrolled in this study. The mean gestational age (GA) and birth weight (BW) were (32.0±2.8) weeks and (1767±571) g. Among these patients, 72.3% were male, 18.0% small for gestational age (SGA), 20.6% fetal distress, 38.7% delivered by cesarean section, 21.4% multiple births and 15.5% Apgar score ＜7 at 5 mira Among the infants whose GA≤34 weeks, only 25.0%received antenatal steroids. Compared to South-eastern area, infants of Mid-western area had larger GA or BW, and higher rates of SGA, fetal distress, cesarean section and multiple births, and lower rate of antenatal steroid use (P =13.384, P=0.000). Median length and cost of hospital stay for survived infants were 18.0 days and 16 500 Yuan (CNY). Infants in South-eastern area had longer length and higher cost of hospital stay than those in Mid-western (P<0.01). Conclusions Both of the application and effectiveness of rescue respiratory therapies make great improvement in our country in the last years, but with regional variation. Great quality improvement in neonatal intensive care should be made in our country, especially in Mid-western China. Key words: Respiratory distress syndrome, newborn; Respiratory therapy; Prognosis