Respiratory Distress in Late Preterm Neonates: An Experience From a Tertiary Care Hospital
Poornima Kulkarni, Harshith Raviraj Shetty, Praveen Bagalkot, Vijay Kulkarni
Abstract
Background and Aim: Respiratory distress is associated with significant morbidity and mortality in late preterm neonates compared with that in term neonates. There are only a few studies on respiratory distress in late preterm neonates. In this study, we aimed to determine the incidence, causes, and short-term outcomes of respiratory distress in late preterm neonates.
Materials and Methods: This was a prospective, observational study conducted in a tertiary care hospital in North Karnataka (India). Late preterm neonates with respiratory distress admitted to the NICU were considered for the study. Neonates weighing > 2 kg were monitored using the Downes score, and the neonates weighing < 2 kg were monitored using the Silverman score. The short-term outcomes were determined based on the duration of assisted ventilation, duration of hospital stay, and mortality.
Results: Of the 404 late preterm births, 80 neonates had respiratory distress, showing an incidence of 19.80%. The most common causes of respiratory distress were transient tachypnea of the newborn (TTNB; 32.50%) and respiratory distress syndrome (RDS; 30%). The other causes included perinatal asphyxia, congenital pneumonia, and meconium aspiration syndrome. The mortality rate was found to be 1.25%. In a maximum number of the neonates, the duration of the hospital stay was 1 to 2 weeks (61.25%). Respiratory distress was observed in a higher percentage of male neonates (65%) than that in the female neonates (35%).
Conclusions: The incidence of respiratory distress in late preterm neonates was found to be high. TTNB and RDS were the most common causes of respiratory distress. Also, the risk of mortality due to respiratory distress in late preterm neonates is low.
The decision to induce delivery in the late preterm period is crucial to the neonatal outcome. The benefits and risks of late preterm delivery must be weighed, as a prudent choice goes a long way in benefitting the neonate. Hence, prolonging pregnancy to at least 36 weeks will play a major role in reducing the severity of respiratory morbidity.
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