A study of causes of respiratory distress in neonates presenting within 72 hours

Abstract

Objectives: to determine the prevalence of known causes of respiratory distress (RD) in neonates within 72 hours and their immediate clinical outcome.

Material and methods: All inborn and out born neonates admitted in Neonatal Unit of Pediatric Department of BRD medical College, Gorakhpur who developed RD within 72 hours of life were studied. Neonates with birth weight less than 1000 grams and less than 28 wks of gestation were excluded from the study.

Result: Out of 1032 neonates screened, 330 neonates (31.98%) admitted with features of RD. Male neonates were two third (67.88%) with M: F ratio of 2.1: 1 and two third of them preterm. Sepsis with pneumonia was found to be the most common cause of RD in neonates (46.36%) followed by hypoxic ischemic encephalopathy (19.09%), hyaline membrane disease(HMD) (13.13%), meconium aspiration syndrome (11.52%), transient tachypnea of neonates (7.27%) and congenital heart disease (2.42%). Eighty five percent neonates were delivered outside, out of these 55.2% were delivered at home by untrained birth attendant. Overall mortality was seen in 31.52%, which was highest in HMD (52.3%) and highest (38.9%) amongst neonates of gestational age < 37 weeks. Two twenty nine (69.39%) neonates of RD were kept on ventilator, out of them 99(30.0%) expired, maximum mortality was seen in HMD.

Conclusion: Sepsis with pneumonia was the common cause of admission with features of RD. Mostly these neonates were preterm, delivered outside mainly at home, weighing <2500gm with common responsible organism was Klebsiela. Highest mortality was seen in HMD.