Recurrent respiratory distress syndrome in successive preterm pregnancies (original) (raw)
Related papers
BMC Pregnancy and Childbirth, 2016
Background: Although respiratory distress syndrome (RDS) is considered a disease of prematurity, there is evidence to suggest heterogeneity between early and late gestation RDS. We examined the epidemiologic features of RDS occurring at early and late gestation. Methods: We conducted a retrospective cohort study including live births in the United States in 2005-06, with information obtained from the National Center for Health Statistics. Early (<32 weeks) and late gestation RDS (≥39 weeks) were contrasted in terms of risk factors and associations with pregnancy complications, obstetric intervention and co-morbidity. Logistic regression was used to quantify the effects of risk factors, while other associations were quantified descriptively. Results: There were 27,971 RDS cases, yielding an incidence of 6.4 per 1000 live births. Early and late gestation RDS differed in terms of risk factors, with factors such as multi-fetal gestation more strongly associated with early (adjusted odds ratio [aOR] 11.6, 95 % confidence interval 11.0-12.2) compared with late gestation RDS (aOR 3.66, 95 % confidence interval 2.68-4.98). The morbidity correlates of early and late gestation RDS also differed substantially; neonatal seizures were less strongly associated with early (OR 5.90, 95 % confidence interval 3.67-9.47) compared with late gestation RDS (OR 33.1, 95 % confidence interval 27.2-40.2), while meconium aspiration syndrome was not significantly associated with early gestation RDS (OR 1.87, 95 % confidence interval 0.94-3.72) and very strongly associated with late gestation RDS (OR 39.8, 95 % confidence interval 34.7-45.6). Conclusions: Differences in risk factors and morbidity correlates of early and late gestation RDS suggest that these entities represent two distinct diseases.
Neonatal respiratory distress syndrome: are risk factors the same in preterm and term infants?
The Journal of Maternal-Fetal & Neonatal Medicine, 2016
Neonatal respiratory distress syndrome: are risk factors the same in preterm and term infants? Objective: to analyze respiratory distress syndrome (RDS) incidence and risk factors at different gestational age. Methods: we considered data from 321,327 infants born in Lombardy, a Northern Italian Region. We computed multivariate analysis to identify risk factors for RDS by dividing infants in early and moderate preterm, late preterm and term infants. Results: Low birth weight is the main risk factor for RDS, with higher odds ratio in term births. The risk was higher in infants delivered by cesarean section and in male, for all gestational age. Pathological course of pregnancy resulted to increase the risk only in late preterm and term infants. Maternal age and multiple birth were not associated with increased risk in any group. Babies born at term after assisted conception were at higher risk of RDS. Conclusion: Our analysis suggests as some risk factors do not influence RDS incidence in the same way at different gestational age.
Factors associated with respiratory distress syndrome in preterm neonates
Global Pediatrcs, 2023
Background: Prematurity is one of the primary causes of infant death in Afghanistan, and it complicates a variety of critical issues, such as respiratory distress syndrome (RDS). Although RDS has been associated with serious consequences, there is a lack of scientific information on the associated factors of this problem in Afghanistan; hence, this study was undertaken to fill that gap. The purpose of this study was to find the occurrence rate and associated factors of RDS in premature neonates. Methods: This retrospective cross-sectional study was conducted at the Neonatal Intensive Care Unit of the French Medical Institute for Mothers and Children Hospital in Kabul City, Afghanistan during 2020–2021. Statistical analysis was performed by SPSS 26 and specific statistical methods. Results: A total of 78 preterm newborns were enrolled in this study, and respiratory distress syndrome developed in 51.3% of them. Based on gestational age, the occurrence rates of RDS within groups of extremely, early, moderate and late preterm neonates were 100%, 55.6%, 44%, and 35.7% respectively. The occurrence of RDS was found to be 100% in extremely low birth weight, 56.2% in very low birth weight, and 58.8% in low birth weight neonates. The gestational ages of these infants had a positive correlation with birth weights (r = 0.648, p = 0.01, n = 78). The preterm neonates in the RDS group versus the non-RDS group had a mean birth weight of (1610±314.4 g vs 1981±520.3 g,P = 0.005), a mean gestational age of (31.65±2.2 w vs 33.18± 2.10 w,P = 0.003), and a mean hemoglobin level of (13.85± 3.28 g vs16.09± 3.26 g, P = 0.003). There was a significant association between RDS and neonatal anemia (AOR=5.9, P = 0.008), neonatal sepsis (AOR=4.2, P = 0.01), vaginal delivery (AOR=8.7, P = 0.01), delivery at low-resourced settings (AOR=2.7, P = 0.01), PROM (AOR=4, P = 0.02), and antepartum hemorrhage (6.9, P = 0.01). The mortality rate in preterm neonates was found to be 26.8% that was significantly associated with very and extremely low birth weights (AOR=8.2, P = 0.03), early and extremely preterm births (AOR=6.3, P = 0.03), female gender (AOR=3.8, P = 0.04), antepartum hemorrhage (AOR=4.6, P = 0.01) and PROM (AOR=5.7, P = 0.01). Conclusions: RDS was highly prevalent in preterm newborns, and the highest rates were seen within groups of extremely preterm and extremely low-birth-weight newborn babies. RDS was found to be associated with lower neonatal birth weight, gestational age, and hemoglobin level, as well as neonatal anemia, neonatal sepsis, vaginal delivery, birth in low-resource settings, PROM, and antepartum hemorrhage. The neonatal mortality in preterm neonates was higher than high-income country. Proper management of the aforementioned associated factors will reduce the incidence of RDS and neonatal mortality in preterm neonates.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2012
Objectives: To develop prediction models for long-term respiratory morbidity. To explore if respiratory distress syndrome (RDS) is a risk-indicator for long-term respiratory morbidity and to identify other perinatal risk-indicators for long-term respiratory morbidity. Study design: In the Dutch POPS cohort 1338 live born infants delivered in The Netherlands in 1983, either before 32 completed weeks gestation and/or with a birth weight below 1500 g, were followed prospectively. We used multivariable logistic regression analyses to construct three prediction models for respiratory morbidity at 2, 5 and 19 years of age. Results: At 2 years of age, maternal smoking (adjusted OR 1.5, 95% CI 1.0-2.4), prolonged rupture of membranes (adjusted OR 2.3, 95% CI 1.3-4.1), pre-eclampsia (adjusted OR 1.9, 95% CI 1.1-4.1), male gender (adjusted OR 1.5, 95% CI 1.1-2.0) and BPD (adjusted OR 1.9, 95% CI 1.1-3.2) were significantly associated with respiratory morbidity. Prolonged rupture of membranes (adjusted OR 3.7, 95% CI 1.6-8.5), family history of asthma (adjusted OR 5.9, 95% CI 2.7-13.0) and BPD (adjusted OR 1.8, 95% CI 1.1-3.0) were significantly associated with respiratory morbidity at 5 years of age. At 19 years of age only higher social class was associated with decreased respiratory morbidity (adjusted OR 0.64, 95% CI 0.41-0.99). The areas under the curves (AUC) were 0.65, 0.71 and 0.61 respectively. The prediction models for respiratory morbidity at 2 and 5 years of age showed a good calibration, while the calibration plot for respiratory morbidity at 19 year was less optimal. Conclusions: RDS is not a risk-indicator for long-term respiratory morbidity at 2, 5 and 19 years in this cohort (OR 1.2, 95% 0.88-1.7; 1.3, 95% 0.88-2.0; OR 0.91, 95% 0.56-1.5 respectively). Future obstetric studies interested in the effect of a specific perinatal intervention on long-term respiratory morbidity, should consider taking bronchopulmonary dysplasia (BPD) as primary outcome instead of RDS. ß
Respiratory Morbidity in Late Preterm Births
Jama-journal of The American Medical Association, 2010
Context Late preterm births (34 0 ⁄7-36 6 ⁄7 weeks) account for an increasing proportion of prematurity-associated short-term morbidities, particularly respiratory, that require specialized care and prolonged neonatal hospital stays.
American Journal of Obstetrics and Gynecology, 2003
We sought to define the risk of neonatal respiratory distress syndrome (RDS) as a function of both lecithin/sphingomyelin (L/S) ratio and gestational age. Amniotic fluid L/S ratio data were collected from consecutive women undergoing amniocentesis for fetal lung maturity at Yale-New Haven Hospital from January 1998 to December 2004. Women were included in the study if they delivered a live-born, singleton, nonanomalous infant within 72 hours of amniocentesis. The probability of RDS was modeled using multivariate logistic regression with L/S ratio and gestational age as predictors. A total of 210 mother-neonate pairs (8 RDS, 202 non-RDS) met criteria for analysis. Both gestational age and L/S ratio were independent predictors of RDS. A probability of RDS of 3% or less was noted at an L/S ratio cutoff of ≥3.4 at 34 weeks, ≥2.6 at 36 weeks, ≥1.6 at 38 weeks, and ≥1.2 at term. Under 34 weeks of gestation, the prevalence of RDS was so high that a probability of 3% or less was not observed by this model. These data describe a means of stratifying the probability of neonatal RDS using both gestational age and the L/S ratio and may aid in clinical decision making concerning the timing of delivery.
2016
AbstractObjectives To study the neonatal respiratory morbidity in late-preterm neonates.Materials and methodsThis study was done over a period of 6 months (November 2014–April 2015) including 120 late-preterm births at a tertiary referral center.ResultsAmong the 120 late-preterm babies, 42 (35 %) developed respiratory morbidity. Respiratory distress syndrome (RDS) developed in 43 % of the babies who had not received steroid prophylaxis against 25.8 % receiving the same (p < 0.05). Among the indicated late-preterm deliveries, 45 % of babies developed respiratory morbidity in comparison with 22 % of the babies born following spontaneous onset of labor (p < 0.05). In the neonates with respiratory morbidity, male babies had a higher incidence than their female counterparts (48 vs. 24 % p < 0.05). Severity of RDS declined from 57 % for babies born at 34 weeks of gestation to 26.3 % for those born at 36 weeks (p 0.14). With each advancing week of gestation a significant reduction...
2015
Objective: To compare the incidence of respiratory distress syndrome (RDS) in late preterm infants at gestational age of 34 weeks and 35-36 weeks and also to compare the rates of short term neonatal complications among infants at gestational age of 34, 35-36 weeks and term (37-40 weeks). Materials and Methods: This study was a retrospective cohort design. Two hundred late preterm (99 cases for GA 34 weeks and 101 cases for GA of 35-36 weeks) and 100 normal term neonates were recruited. RDS and short-term complications in neonates who were born at the Bhumibol Adulyadej Hospital from January 2011 to June 2014 were compared. The data were analyzed with Chi-square test, Student's t-test and analysis of variance where appropriate. Result: RDS rate was higher in the late preterm group with GA 34-34 6/7 weeks than in the group with GA 35-36 6/7 weeks (15% and 4.0% respectively with p = 0.015). There was no RDS in normal term (GA 37-40 weeks) babies. The short-term complications: oxygen requirement, hyperbilirubinemia, hypoglycemia, hypothermia, NICU admission and hospital stay were also higher in 34-34 6/7 week gestation group. Conclusion: The incidence of RDS is significantly higher in late preterm with GA 34-34 6/7 weeks than other groups.
Antenatal corticosteroids and fetal lung immaturity in preterm birth
Heliyon, 2020
Background: Respiratory distress syndrome (RDS), a consequence of lung immaturity, is a serious complication of preterm birth and the primary cause of early neonatal mortality. Administration of antenatal steroids is a standard care method for mothers with anticipated preterm labor. However, the gestational age range at which antenatal corticosteroids (ACS) provide benefit has been subjected to debate. This study aimed to find the prevalence of ACS use in patients that developed/did not develop RDS. Methods: This cross-sectional study was conducted at Rafidia governmental surgical hospital. It is based on the data obtained from the files of mothers who gave birth to premature babies and from a face-to-face interview. One hundred and twenty-eight data collection forms were completed over a period of seven months. Results: Approximately 64% of mothers, mothers who gave birth to premature babies, were given ACS, and about 33% of premature neonates developed RDS. Mothers who gave birth to newborns with RDS have lower odds of being administered ACS by 44% (OR ¼ 0.44, CI ¼ 0.202-0.94, p value ¼ 0.034). However, the association became statistically not significant after adjusting gestational age, birth weight, gender, mother's age, intrauterine growth restriction (IUGR), mode of delivery and gestational hypertension (OR ¼ 0.462, CI ¼ 0.137-1.56, p value ¼ 0.212). Higher risk of RDS was significantly associated with lower gestational age (p-value < 0.001) and IUGR after adjustment (p value ¼ 0.035). However, no significant association could be found between RDS and mode of delivery (p value ¼ 0.730), maternal age (p value ¼ 0.63) and gender of the baby (p value ¼ 0.22). Conclusions: the overall prevalence of RDS in preterm infants was 33.3% and the identified risk factors were lower gestational age and IUGR. We showed that the administration of ACS wasn't significantly associated with the development of RDS after adjusting gestational age, birth weight, gender, mother's age, IUGR, mode of delivery and gestational hypertension, as the administration of ACS didn't fully meet the international guidelines.