Evaluation of Morbidities and Complications of Neonatal İntensive Care Unit Patients with Respiratory Disorders at Different Gestational Ages

Abstract

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points

Risk Factors for Mortality or Major Morbidities of Very Preterm Infants: A Study from Thailand

“…36 A study from the Netherlands reported that the PPHN rate in neonates with GA less than 30 weeks and/or extremely low birth weight infants was 11.5% (12/104), 37 while no PPHN cases were reported in a study on Turkish very preterm neonates. 38 The common causes of PPHN in very preterm neonates in this study were pneumonia and moderate or severe RDS. In a study from the Netherlands, multivariable logistic regression found that PPHN was associated with death, 37 which is similar to the findings in our study.…”

“…The first cranial ultrasound was performed within 3-5 days of birth for neonates with GA less than 26 weeks and 7-14 days of birth in neonates with GA of 26-32 weeks by a pediatric radiologist. The second cranial ultrasound was performed at GA 4-6 weeks of life or at [37][38][39][40][41][42] weeks in regards to postmenstrual age. Targeted neonatal echocardiography was performed by a neonatal fellow and/or pediatric cardiologist when a neonate was suspected to have patent ductus arteriosus (PDA) or PPHN.…”

Gebelik Yaşı ≤32 Hafta Olan Prematüre Bebeklerde 25-Hidroksivitamin D Düzeyleri ve Geç Başlangıçlı Sepsis Riski

“…Compared to past few years, survival rates of preterm infants have evidently raised with advances in perinatal and neonatal care (17). As a result, rates of very low birth weight (VLBW) and extremely low birth (ELBW) infants has increased.…”

Intrauterine Inflammation, Excessive Fetal Growth and Respiratory Morbidities in Moderate-To-Late Preterm Neonates

“…Respiratory morbidities within the first few days of life are common and often life-threatening without prompt detection and treatment [ 1 ]. Respiratory failure requiring invasive mechanical ventilation decline with gestational age from approximately 95% for extremely preterm neonates (<28 weeks of gestation) to approximately 60% in very preterm neonates (28–32 weeks of gestation) and <1% for term neonates (≥37 weeks of gestation) [ 2 ]. Intrauterine inflammation is another key control variable of respiratory morbidity in neonates.…”

“…Presumably because of relatively more favorable outcomes related to respiratory morbidities in moderate-to-late preterm neonates than in their extremely and very preterm peers, respiratory morbidities other than RDS in this group of neonates have not been fully investigated, especially in relation to intrauterine inflammation. However, considering that the incidence of moderate-to-late preterm birth is approximately 5.5 times higher than that of extremely and very preterm birth [ 8 ] and that the prevalence of respiratory morbidities requiring invasive mechanical ventilation is approximately 30 times higher for moderate-to-late preterm neonates than for term infants [ 2 ], precise understanding of respiratory morbidities subsequent to intrauterine inflammation may improve the safety of this population. This study aimed to determine whether intrauterine inflammation – represented by the presence of funisitis, chorioamnionitis, and elevation of inflammatory biomarkers – is associated with respiratory morbidities requiring prolonged invasive mechanical ventilation in moderate-to-late preterm neonates.…”