Analysis of neonatal respiratory distress syndrome among different gestational segments

To find more effective diagnosis and treatment of NRDS through comparatively analyzing the different gestational neonates with respiratory distress syndrome in risk factors, clinical characteristics, treatment and prognosis.

The clinical data of 232 neonates were retrospectively analyzed who had been admitted into the neonatal intensive care unit and diagnosed with NRDS from January 2008 to December 2010. These cases were divided into three groups according to gestational age, which included full-term group, late preterm and early preterm group. Statistical analysis was used to detect the differences of relative factors among the three groups.

For pathogen, the full-term and late preterm infants accounted for more than 50% The majority of full-term infants were less than 39 weeks, taking up 83.7%. As many as 61.1% of the late preterm infants were born at maternal age over 30 years. The incidence of Cesarean section was high among the three groups, especially the full-term (90.7%) and late preterm group (86.1%). For clinical features, full-term infants had late onsets more than 12 h after birth. Air bronchogram could be found commonly in early preterm neonates, influencing 92% of them. However, it was rare in the other two groups. The incidence of lung infection in each group was all about 50%. In addition, Gas leakage and PPHN were more common complications in full-term and late preterm group, while for the early preterm group was the bronchopulmonary dysplasia and intracranial hemorrhage. For treatment, the proportions of full-term infants receiving application of HFOV and NO were 57.0% and 24.4%, and for late preterm infants were 36.1% and 22.2%. The application of HFOV and NO was not as much to early preterm infants as other groups. There was no significant difference in the duration of invasive ventilation between all groups. However, the noninvasive ventilation time after extubation was as long as 10.1±0.5 days in early preterm infants. The proportions of infants receiving application of PS were 53.5%, 83.3% and 81.8%, respectively. OI values improved greatly 2 h after application of PS on early preterm infants. However, the obvious difference was found only after 24 h for full-term and late preterm infants.

Besides early preterm infants, full-term and late preterm have the growing trend in the pathogenesis of NRDS. Infants of different gestational age have their own characteristics of the risk factors, which cesarean section impacts greatly on the incidence of term and late preterm infants. The clinical feature, chest X-ray changes and common complications were characteristics between term and premature infants with NRDS. The PS treatment work slower in term and late preterm infants, who needed more HFOV and NO treatment.