Determinants of outcome in newborns with respiratory distress in Osogbo, Nigeria

Abstract

INTRODUCTIONRespiratory distress is one of the commonest presentations necessitating hospital admission of newborns.1 About 15% of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop have significant respiratory symptoms; this is even higher for infants born before 34 weeks' gestation.2,3 The clinical presentations of respiratory distress in the newborn include difficulty with breathing (nasal flaring, recessions or retractions in the intercostal, subcostal, or supracostal spaces, grunting, head nodding); too fast breathing (tachypnoea -respiratory rate more than 60 breaths per minute); too slow or shallow breathing (bradypnoea -respiratory rate less than 30 per minute, apnea); noisy breathing (stertor, expiratory ABSTRACT Background: Respiratory distress is one of the commonest presentations necessitating hospital admission in newborn unit. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to apnoea, respiratory failure, cardiopulmonary arrest and death. Methods: A cross-sectional and descriptive study of newborns with respiratory distress admitted into the SCBU of LAUTECH Teaching Hospital, Osogbo, Nigeria. Respiratory distress was diagnosed by grunting, inspiratory stridor, nasal flaring and tachypnea (more than 60 breaths per minute), retractions in the intercostal, subcostal, or supracostal spaces and cyanosis. At admission, every neonate had a complete physical examination. Results: Of 625 babies admitted, 384 (61.4%) were males while 241 (38.6%) were females and 164 (26.2%) had respiratory distress. Respiratory distress was commoner among the preterms than term newborns.  2 = 44.7, p = 0.001. Leading causes of respiratory distress among the preterms were hyaline membrane disease, septicaemia, while among the term babies were perinatal asphyxia, transient tachypnoea of newborn and meconium aspiration. Sixty (36.6%) of the 164 babies with respiratory distress died. While 40.2% of the preterms died mainly from causes like hyaline membrane disease and septicaemia, 31.3% of term babies died from causes like perinatal asphyxia and meconium aspiration. Mortality from hyaline membrane disease was 46.9%, while perinatal asphyxia and meconium aspiration accounted for 38.9% and 40.0% respectively. Conclusions: Respiratory distress is therefore, a very common neonatal problem and it causes death of more than third of those affected. Emphasis should be geared towards reduction of preterm delivery, control of asphyxia and neonatal sepsis in order to reduce neonatal mortality in our environment.

Analysis of Neonatal Respiratory Distress in Neonatal Intensive Care Unit at Nepal Medical College

“…Adebami et al found respiratory distress due to congenital heart disease in 6.1% of the study participants. 17 In our study, congenital heart disease was the cause for respiratory distress in 6.4% of neonates.…”

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

“…Higher mortality rate accompanied higher incidence of RDS, MAS, and pneumonia while higher survival rate with increased incidence of TTN. During the period of the study, the case fatality rate was (38.9%) [32,35]. Many variables had a great effect on the outcome of our studied cases as had an odds ratio >1 like male gender, RDS, CDH, pneumonia, apnea, tachypnea >60/min, cyanosis and irritability where apnea had the highest odd ratio of clinical signs.…”

The epidemiology, risk factors, mortality rate, diagnosis, etiologies and treatment of neonatal respiratory distress: a scoping review

“…The most accepted diagnosis for NRD was based on the clinical presence of at least one or two of the elements of the following three signs: an abnormal respiratory rate ( tachypnoea [respiratory rate above 60 breaths/minute], bradypnoea [respiratory rate less than 30 breaths/minutes], respiratory pauses [an absence of breathing movements for a period less than 20 seconds] and apnoea [an absence of breathing movements for a period greater than 20 seconds]), signs of laboured breathing (expiratory grunting, nasal aring, intercostal recessions, xiphoid recession and thoraco-abdominal asynchrony) and generalised or localised cyanosis (1,3,4,8,16,19,21,25,27,(31)(32)(33)35,53,(63)(64)(65). The rest of the clinical examination is aimed at investigating the aetiology of NRD.…”