Risk Factors and Clinical Characteristics of Neonatal Acute Respiratory Distress Syndrome Caused by Early Onset Sepsis

Abstract

PurposeTo identify risk factors associated with the development of acute respiratory distress syndrome (ARDS) in infants with early onset sepsis (EOS) and to describe the clinical features.MethodsA retrospective study was conducted at the Children’s Hospital of Chongqing Medical University between January 2000 and October 2020. The infants were divided into ARDS and non-ARDS groups. Clinical characteristics and risk factors were compared between the two groups.ResultsTwo hundred fifty infants (58 with ARDS) were included. Smaller gestational age, lower birth weight (LBW), lower serum albumin level, a higher rate of preterm birth, premature rupture of membranes, antenatal steroid exposure, and lower Apgar score were associated with an increased development of ARDS by univariate analysis (P < 0.05). LBW (β = −0.001, P = 0.000, OR: 0.999, 95% CI: 0.998–0.999) and low serum albumin levels (β = −0.063, P = 0.022, OR: 0.939, 95% CI: 0.889–0.991) were identified as independent risk factors for the development of ARDS by logistic regression analysis. A higher frequency of complications, including persistent pulmonary hypertension, intraventricular hemorrhage, pulmonary hemorrhage, septic shock, and bronchopulmonary dysplasia, was found in the ARDS group (P < 0.05). The rate of mortality was higher for those in the ARDS group than for those in the non-ARDS group (46.6% vs. 15.6%, χ2 = 24.205, P = 0.000).ConclusionAcute respiratory distress syndrome (ARDS) in EOS could lead to a higher frequency of complications and mortality. The risk factors for the development of ARDS were LBW and low serum albumin levels.

Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia

“…Prematurity and low birth weight are known common risk factors for neonatal sepsis ( 2 , 9 , 21 ). This study did not show associations with neonatal sepsis.…”

“…Out of 5.9 million child deaths in 2015, almost 1 million deaths occurred on the first day of life and approximately 2 million deaths occurred in the first week of life. Among the main cause of neonatal deaths, neonatal sepsis was the third cause, accounting for 15% of deaths globally (8). In developed countries, the incidence of neonatal sepsis varies from one to four cases per 1,000 live births, with significant differences over time and geography (3).…”

“…A limited amount of information on the risk factors for newborn sepsis in Africa and other developing nations was accessible despite the significant burden of neonatal sepsis (8). A delay in diagnosis of the disease could contribute to a delay in treatment, increasing the mortality rate by 50%.…”

“…In developed countries, the incidence of neonatal sepsis varies from one to four cases per 1,000 live births, with significant differences over time and geography ( 3 ). Ninety-eight percent of global neonatal deaths occur in developing countries, especially in sub-Saharan Africa ( 9 , 10 ).…”

“…Studies have been conducted to determine the prevalence and risk factors for neonatal sepsis in neonates in both developing and developed countries ( 4 , 9 , 12 , 13 ). In Ethiopia, limited studies pointed out the different factors for neonatal sepsis, namely, history of maternal UTI/STI ( 4 , 18 – 20 ), place of delivery ( 4 , 18 ), mode of delivery ( 18 , 21 ), APGAR score <7/5 min ( 4 , 19 , 21 ), premature rupture of membrane ( 4 , 19 , 20 ), respiratory distress syndrome ( 19 , 20 , 22 ), intrapartum fever ( 4 ), birth weight ( 21 ), meconium aspiration ( 22 ), gestational week ( 20 , 21 ), and not crying immediately at birth ( 4 ).…”