Severe respiratory distress in term infants born electively at high altitude

Ahmad F Bakr,Mohammad M Abbas

doi:10.1186/1471-2393-6-4

Abstract

BackgroundWe studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude.MethodsWe prospectively studied the charts of term babies born in Taif Maternity Hospital (1640 m above sea level) between 1/1/2004 and 31/10/2004 who developed RDS and required mechanical ventilation.Results8634 deliveries occurred from 37–<41 weeks; 13 (0.15%) had RDS requiring mechanical ventilation. Seven infants delivered at 37–<38 weeks, (OR for RDS = 26 95%CI -4.6 to 5.8), five delivered at 38–<39 weeks, (OR for RDS = 10 95%CI -4.9 to 5.4) and one delivered at >39 weeks. Six of 13 infants were electively delivered without documented lung maturity.ConclusionInfants born at 37 and 38 weeks' gestation remain at significantly increased risk for severe RDS. Elective delivery is responsible for 50% of the potentially avoidable cases. Our data suggest that the altitude does not seem to influence the incidence of severe RDS in term infants born electively.

Highlights

We studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude
Infants born at 37 and 38 weeks' gestation remain at significantly increased risk for severe RDS
Our data suggest that the altitude does not seem to influence the incidence of severe RDS in term infants born electively

Summary

Introduction

We studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude. Respiratory distress syndrome (RDS) is a common problem in neonatal practice, usually seen in premature babies. Iatrogenic RDS is defined as RDS resulting from elective delivery [1]. Nonadherence to the guidelines [4] designed to minimize the risk of electively delivering an immature infant can lead to iatrogenic RDS. This problem is further augmented in developing countries where good antenatal care is not always the rule. The concept of maturity is even more different in some communities, including the educated, in developing countries

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