Kumar A, Bhat B V
Department of Pediatrics (Neonatal Division), Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry.
Indian J Pediatr. 1996 Jan-Feb;63(1):93-8. doi: 10.1007/BF02823875.
The present prospective study was conducted to find out the incidence, etiology and outcome of respiratory distress (RD) in newborns. All newborns (n = 4505), delivered at this hospital over a period of 13 months, were observed for respiratory problems. Relevant antenatal, intranatal and neonatal information was noted. Cases were investigated for the cause of respiratory distress and followed up for the outcome. The overall incidence of RD was 6.7%. Preterm babies had the highest incidence (30.0%) followed by post-term (20.9%) and term babies (4.2%). Transient tachypnea of newborn (TTN) was found to be the commonest (42.7%) cause of RD followed by infection (17.0%), meconium aspiration syndrome (10.7%), hyaline membrane disease (9.3%) and birth asphyxia (3.3%). TTN was found to be common among both term and preterm babies. While Hyaline membrane disease (HMD) was seen mostly among preterms, and Meconium aspiration syndrome (MAS) among term and post-term babies. Overall case fatality ration for RD was found to be 19%, being highest for HMD (57.1%), followed by MAS (21.8%) and infection (15.6%). Our results indicate that RD is a common neonatal problem. TTN accounts for a large proportion of these cases. MAS and infection also contribute significantly and are largely preventable. Without adequate ventilatory support HMD and MAS carry high mortality.
本前瞻性研究旨在查明新生儿呼吸窘迫（RD）的发病率、病因及转归。对该医院13个月内分娩的所有新生儿（n = 4505）进行呼吸问题观察。记录相关的产前、产时及新生儿期信息。对呼吸窘迫病例进行病因调查并随访转归情况。RD的总体发病率为6.7%。早产儿发病率最高（30.0%），其次是过期产儿（20.9%）和足月儿（4.2%）。新生儿短暂性呼吸急促（TTN）被发现是RD最常见的病因（42.7%），其次是感染（17.0%）、胎粪吸入综合征（10.7%）、肺透明膜病（9.3%）和出生窒息（3.3%）。TTN在足月儿和早产儿中均很常见。而肺透明膜病（HMD）多见于早产儿，胎粪吸入综合征（MAS）多见于足月儿和过期产儿。RD的总体病死率为19%，其中HMD最高（57.1%），其次是MAS（21.8%）和感染（15.6%）。我们的结果表明，RD是一个常见的新生儿问题。TTN占这些病例的很大比例。MAS和感染也有显著影响，且在很大程度上是可预防的。若无足够的通气支持，HMD和MAS的死亡率很高。
