Increasing incidence of respiratory distress in neonates.

AIM

To document the change in the incidence of respiratory distress (RD), related interventions and mortality in neonates admitted to primary, secondary and tertiary neonatal units within a geographically defined population over a period of 30 years.

METHODS

RD was defined as a clinical picture irrespective of the etiology. Information was collected retrospectively for 1974, 1984, 1994 and 2004 from all neonatal units in Switzerland.

RESULTS

In the 30 years studied the proportion of infants hospitalized with RD increased from 1.9% to 3.8% of the whole neonatal population and from 30% to 53% of all infants admitted to a neonatal unit. Treatment of RD changed significantly. Mechanical ventilation decreased from 31% to 16%, nasal CPAP increased from almost 0% to 26% and surfactant administration increased from 0% to 53% in infants with hyaline membrane disease. Overall mortality decreased in infants with RD from 15.5% to 3.5%.

CONCLUSIONS

The incidence of RD in infants admitted to neonatal units doubled over the last 30 years in a geographically defined neonatal population. This rise can predominantly be ascribed to infants with birth weight >2500 g and may reflect the corresponding increase in the rate of caesarean section.