Increasing incidence of respiratory distress in neonates

Ersch, Jörg; Roth‐Kleiner, Matthias; Baeckert, P; Bucher, Hans Ulrich

doi:10.1111/j.1651-2227.2007.00440.x

Cited by 52 publications

(37 citation statements)

References 16 publications

(18 reference statements)

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“…7,10,32,40,42,47,50,53,58,59,62,75,77,85,86,89,94,96,97,109,116,117,125,127,135,137 In contrast, however, the incidence of birth asphyxia, trauma, and meconium aspiration is lower, and these advantages of elective cesarean delivery have been reviewed elsewhere in this issue of Clinics.…”

Section: Respiratory Morbidity In Infants Delivered By Cesarean Deliverymentioning

confidence: 99%

Elective Cesarean Section: Its Impact on Neonatal Respiratory Outcome

Ramachandrappa¹,

Jain²

2008

Clinics in Perinatology

157

108

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The transition from a fluid filled lung to one filled with air in a very short period of time is one of the biggest challenges a newborn faces after birth. Respiratory morbidity as a result of failure to clear fetal lung fluid is not uncommon, and can be particularly problematic in some infants delivered by elective cesarean section (ECS) without being exposed to labor. The increasing rates of cesarean deliveries in the United States and worldwide, have the potential for a significant impact on public health and health care costs due to the morbidity associated with this subgroup. Whereas the occurrence of birth asphyxia, trauma, and meconium aspiration is reduced by elective cesarean delivery, the risk of respiratory distress secondary to transient tachypnea of the newborn, surfactant deficiency, and pulmonary hypertension is increased. It is clear that physiologic events in the last few weeks of pregnancy coupled with the onset of spontaneous labor are accompanied by changes in the hormonal milieu of the fetus and its mother, resulting in preparation of the fetus for neonatal transition. Rapid clearance of fetal lung fluid is a key part of these changes, and is mediated in large part by transepithelial sodium reabsorption through amiloride-sensitive sodium channels in the alveolar epithelial cells, with only a limited contribution from mechanical factors and Starling forces. In this chapter we discuss the respiratory morbidity associated with ECS, the physiologic mechanisms underlying fetal lung fluid absorption and potential strategies for facilitating neonatal transition when infants are delivered by ECS before the onset of spontaneous labor. The changing landscape for human deliveriesCesarean births rose for an tenth straight year in 2006 to a record 31.1% of all deliveries in the United States; this rate is more than 50% higher than in 1996 and is accompanied by a significant drop in the number of women attempting vaginal birth after a previous cesarean delivery (VBAC). 56 ( Fig. 1) Most of the overall increase can be attributed to the increase in the primary cesarean rates, from 14.6% in 1996 to 20.3% in 2005. This rise in the primary cesarean rate coupled with the decrease in the VBAC rate (7.9% in 2005) means that women who have a primary cesarean section have a greater than 90% chance of having a repeat cesarean section, further increasing the overall cesarean rate in the future. 90 Among the many reasons cited for this increase are older women giving birth, multiple gestations from fertility treatments, as well as the concerns of physicians and mothers about the risks of vaginal birth. Cesarean births in low risk or "no risk" mothers where no medical indication can be identified are on the rise and are often referred to as Cesarean Delivery at Maternal Request (CDMR).Address for Correspondence and Reprints: Lucky Jain, MD, MBA, Professor of Pediatrics & Executive Vice Chairman, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta GA 30322, ljain@emory.edu, 404-727-1471. Coauthor...

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Section: Respiratory Morbidity In Infants Delivered By Cesarean Deliverymentioning

confidence: 99%

Elective Cesarean Section: Its Impact on Neonatal Respiratory Outcome

Ramachandrappa¹,

Jain²

2008

Clinics in Perinatology

157

108

View full text Add to dashboard Cite

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“…Early detection of its risk factors and anticipation of the management of its etiologies are imperative [5, 6, 8]. A tremendous decrease in the NRD specific mortality rate has occurred over the past six decades in high-income countries [7–9] due to several innovations in neonatology that are insufficient or non-existent in low-income countries [5, 6, 10]. However, there have been gradual improvements in health infrastructures and level of care in sub-Saharan Africa over time, yet to the best of our knowledge no well-designed and large-sample study has focused on NRD in the recent years.…”

Section: Introductionmentioning

confidence: 99%

Neonatal respiratory distress in a reference neonatology unit in Cameroon: a retrospective analysis of prevalence, predictors, etiologies and outcomes

Tochie¹,

Choukem²,

Langmia³

et al. 2016

Pan Afr Med J

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IntroductionNeonatal respiratory distress (NRD) is a main cause of neonatal morbidity and mortality in developing countries. Early detection of its risk factors and early treatment of its etiologies are major challenges. However, few studies in developing countries have provided data needed to tackle it. We aimed to determine the prevalence, predictors, etiologies and outcome of NRD in a tertiary health care centre of Cameroon.MethodsWe analyzed the hospital files of all newborns admitted to the Neonatal unit of Douala General Hospital from 1st January 2011 to 28th February 2013. NRD was diagnosed based on the presence of one or more of the following signs: an abnormal respiratory rate, expiratory grunting, nasal flaring, chest wall recessions and thoraco-abdominal asynchrony with or without cyanosis, in their files. Socio-demographic and clinical variables of newborns and their mothers were analyzed using logistic regression analysis.ResultsThe prevalence of NRD was 47.5% out of the 703 newborns studied. Acute fetal distress, elective caesarean delivery, APGAR score < 7 at the 1st minute, prematurity, male gender and macrosomia were independent predictors of NRD. The main etiologies were neonatal infections (31%) and transient tachypnea of the newborn (25%). Its neonatal mortality rate was 24.5%, mainly associated with neonatal sepsis and hyaline membrane disease.ConclusionNRD is a frequent emergency and causes high morbidity and mortality. Most of its risk factors and etiologies are preventable. Adequate follow-up of pregnancy and labor for timely intervention may improve the neonatal outcomes.

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“…Between 2000 and 2009, the rates of mortality and major neonatal morbidities including chronic lung disease1 in survivors decreased for infants with a birth weight (BW) of 501–1500 g. However, pulmonary disorders are responsible of over 50% of neonatal deaths in very preterm infants,2 3 and are associated with morbidities that have severe long-term consequences 1 2…”

Section: Introductionmentioning

confidence: 99%