Acute respiratory disorders in the newborn at the Mount Hope Women's Hospital, Trinidad.

This retrospective study was undertaken to determine the incidence of acute respiratory disorders (ARD) in newborns delivered at the Mount Hope Women's Hospital (MHWH) from January 1 to December 31, 1994. The study also examined the relationships between incidence rate of ARD and maternal and neonatal parameters. Hyaline membrane disease (HMD), transient tachypnoea of the newborn (TTN), meconium aspiration syndrome (MAS), persistent fetal circulation (PFC) and pulmonary infection (PI) were identified as ARDs among 5062 live newborns using standard diagnostic criteria. Overall, 174/5062 neonates were diagnosed with ARD to give an incidence of 3.4% (104 males and 70 females). The most common ARD was PI (39%) followed by HMD (29%). The incidence of ARD in preterm infants was 20.6% (100/486) and 1.1% (48/4363) in term neonates. Hyaline membrane disease occurred mainly in the preterm and low birthweight babies. Transient tachypnoea of the newborn and PI were found in all gestational age groups. Asphyxia was present in 10.9% (19/174) at five minutes of age. It was more common in babies who developed HMD and PFC. Forty-one per cent (71/174) of babies with ARD required assisted ventilation. There were 58/174 (33%) deaths. More than a half of those ventilated died (39/71 or 55%); 2/3 of those with airleaks and all those with intraventricular haemorrhage died. Mortality was significantly associated with asphyxia at both one and five minutes of age. There was significantly greater mortality among neonates with HMD as compared to the other ARDs.