“A Study to Correlate Risk Factors and Outcomes With Morbidity and Mortality Pattern of Respiratory Distress in Neonates in Nicu of a Tertiary Care Centre in Rural Setup”

Abstract

Background: One of the most frequent illnesses in the rst 48 to 72 hours of neonatal life is respiratory distress. The most frequent reason for NICU hospitalization and the leading cause of morbidity in newborn is respiratory distress. The present study is aimed to determine and correlate the incidence, risk factors, causes and outcomes of respiratory distress in neonates in a neonatal intensive care unit of a tertiary care facility. Impressive outcomes are achieved when neonatal respiratory illness is diagnosed early and managed with appropriate interventions. Material & Methods: A prospective observational study was conducted for a period of 18 months in the inborn & outborn NICU of Department of Pediatrics, Index Medical College Hospital & Research Centre, Indore after valid approval from Institutional ethics committee on. 100 babies who presented with respiratory distress irrespective of their status at time of delivery (preterm, term or post term) and qualied the inclusion criteria were enrolled after taking written informed consent from the parents/caretakers. Following the admission of the newborn, data were recorded in the predesigned proforma. Statistical analysis was done with P value <0.05 signicant. Out Results: of 100 babies included in the study, 62 were males while 38 were females. Pulmonary cause was the most frequent cause of respiratory distress in newborn out of which TTNB (33%) was the commonest followed by RDS (20%). Prematurity (37%), MSAF (18%), Caesarean section against precipitous labour (9.5%), obstruction/non progression of labour (8%) were the major risk factors to develop. 58% of babies were born via LSCS with MSAF (24.1%), previous Caesarean section (20.7%) and obstructed labour (13.8%) as the main indications. Under treatment intervention,62 (62%) babies required only Oxygen while 20 babies (20%) required CPAP and 18 babies (18%) required mechanical ventilation. Morbidity was seen in 34% of newborns with RD which included sepsis, ROP, IVH, HIE, BPD. Out of 20 deaths,14 babies (70%) were males, and 6 babies (30%) were females. In Conclusion: cidence of respiratory distress was 9.8% among live births. Transient tachypnea of the newborn is the most common cause of respiratory distress in newborn. Antenatal risk factors increase the incidence of RD. Risk factors like Prematurity, meconium-stained liquor, cesarean delivered newborns, obstructed labour, Oligo/polyhydramnios, foetal distress, PROM was associated with respiratory distress in newborns. Prematurity is the most common and most important risk factor for the development of RD in newborn. There was male predominance & most of the babies were delivered via caesarean section. Frequency and severity of RD is inversely related to gestational age and birth weight. Early term and preterm babies constituted majority of the babies with respiratory distress. Most of the babies had mild to moderate respiratory distress with Downe's score between 2-6. RDS was the most common cause for CPAP and ventilation. The mortality rate was 20% among the respiratory distress cases admitted in NICU, rest 80% survived. The most common cause of death was RDS. Early diagnosis and identication of causes of respiratory distress in neonate is critical in the management. The neonatal outcome will improve with efforts made to prevent preterm birth, identify various maternal risk factors and intervene early with appropriate interventions.