Respiratory distress in term neonates in low-resource settings

Sivanandan, Sindhu; Agarwal, Ramesh; Sethi, Amanpreet

doi:10.1016/j.siny.2017.04.004

Cited by 23 publications

(28 citation statements)

References 66 publications

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“…A cohort study reported a 3.5 times increased risk of a sepsis in a premature rupture of membranes in premature neonates [ 30 ], compared to our study, which reported a 2.68 times increased risk. In our study, the risk for LCBIs was higher for neonates with MAS (RR 2.32), however there is no evidence that the use of antibiotics for MAS reduces the rate of sepsis in neonates born through meconium-stained amniotic fluid [ 31 ]. In our study, fetal malpresentation was associated with LCBIs (RR 3.05, 95% CI 2.05–4.53; p < 0.001).…”

Section: Discussionmentioning

confidence: 70%

Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

et al. 2018

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Very little is known about laboratory-confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR) 2.23), duration of NICU stay more than 14 days (RR 1.75), chorioamnionitis in the mother (RR 3.18), premature rupture of membrane in mothers (RR 2.32), neonate born through meconium-stained amniotic fluid (RR 2.32), malpresentation (RR 3.05), endotracheal intubation (RR 3.41), umbilical catheterization (RR 4.18), and ventilator-associated pneumonia (RR 3.17). The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22). The predominant causative organisms were gram-negative pathogens (58%). The results of the present study can be used to design and implement antibiotic stewardship policy and introduce interventions to reduce LCBIs in resource-limited settings.

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Section: Discussionmentioning

confidence: 70%

Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

et al. 2018

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“…Respiratory distress syndrome (RDS) occurs in 4-7% of all neonates. In term newborns, RDS is mostly caused by transient tachypnea of the newborn and pneumonia, less frequently by meconium aspiration syndrome and congenital respiratory system defects [ 88 ]. Preterm infants develop RDS due to immature lungs and insufficient or dysfunctional surfactant.…”

Section: Neonatal Diseases Related To Ros and Intense Inflammationmentioning

confidence: 99%

Two Faces of Heme Catabolic Pathway in Newborns: A Potential Role of Bilirubin and Carbon Monoxide in Neonatal Inflammatory Diseases

Osiak

Wątroba²,

Kapka‐Skrzypczak

et al. 2020

Oxidative Medicine and Cellular Longevity

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In an infant’s body, all the systems undergo significant changes in order to adapt to the new, extrauterine environment and challenges which it poses. Fragile homeostasis can be easily disrupted as the defensive mechanisms are yet imperfect. The activity of antioxidant enzymes, i.e., superoxide dismutase, catalase, and glutathione peroxidase, is low; therefore, neonates are especially vulnerable to oxidative stress. Free radical burden significantly contributes to neonatal illnesses such as sepsis, retinopathy of premature, necrotizing enterocolitis, bronchopulmonary dysplasia, or leukomalacia. However, newborns have an important ally—an inducible heme oxygenase-1 (HO-1) which expression rises rapidly in response to stress stimuli. HO-1 activity leads to production of carbon monoxide (CO), free iron ion, and biliverdin; the latter is promptly reduced to bilirubin. Although CO and bilirubin used to be considered noxious by-products, new interesting properties of those compounds are being revealed. Bilirubin proved to be an efficient free radicals scavenger and modulator of immune responses. CO affects a vast range of processes such as vasodilatation, platelet aggregation, and inflammatory reactions. Recently, developed nanoparticles consisting of PEGylated bilirubin as well as several kinds of molecules releasing CO have been successfully tested on animal models of inflammatory diseases. This paper focuses on the role of heme metabolites and their potential utility in prevention and treatment of neonatal diseases.

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“…Overall, data remain scarce in low resource settings especially for full term neonates with an incidence rate recorded between 1.2 to 7.2% in term live births. In addition, RD morbidity in low resource settings seems to be greater compared to data of high-income countries [9]. As epidemiological trends show an increasing rate of RD in full-term newborns [10,11] we designed this study with the primary objective to assess and describe clinical aspects, causes and management of RD in full and post-term neonates in a tertiary facility in Yaoundé.…”

Section: Introductionmentioning

confidence: 99%

Respiratory distress in Full and Post term neonates: Prevalence, Etiologies and Outcomes in a Tertiary Health Center in Yaoundé

Kue

Nanfack²,

NLEND³

2020

Preprint

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Introduction Respiratory distress (RD) is a common condition for admission of newborns in neonatal care unit (NCU), in both preterm and full-term neonates. Our objective was to describe the clinical features, causes and treatment of RD in full term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). Patients and Method We conducted a cross sectional retrospective study. Full term neonates with RD at EHC from January 2017 to December 2018 were included, assuming clinical signs of RD prior to 48 hours following admission. Factors evaluated: incidence of RD, main etiologies, short term outcomes and risk factors for severity. Data were collected using a chart, then analyzed using software Stata Version 13.Results 186 full term neonates out of 2312 newborn babies admitted in NCU, met the inclusion criteria giving a prevalence rate of RD of 8%. Sex ratio of 2.15 was favoring males; median age at admission was 7.25 hours and 89.2 % were born at a median gestational age of 38 weeks. Clinical signs of RD were dominated by signs of respiratory control with a Silverman score above 4/10 in 64%. The most common etiologies were neonatal infection / pneumonia (45.9%), followed by transient tachypnea. Clinical management was performed using nasal cannula oxygen and antibiotics. Perinatal asphyxia, cyanosis and caesarian section were found to be associated with severe RD in this setting. Mortality rate was 10.4%.Conclusion RD in full term neonates is common in this setting, with neonatal infection as preeminent etiology; the mortality rate is high and the management still inappropriate.

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Respiratory distress in term neonates in low-resource settings

Cited by 23 publications

References 66 publications

Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

Two Faces of Heme Catabolic Pathway in Newborns: A Potential Role of Bilirubin and Carbon Monoxide in Neonatal Inflammatory Diseases

Respiratory distress in Full and Post term neonates: Prevalence, Etiologies and Outcomes in a Tertiary Health Center in Yaoundé

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