Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
Department of Pediatrics and Neonatal Nursing, Wollega University, Nekemte, Ethiopia.
BMJ Open. 2023 Nov 19;13(11):e079063. doi: 10.1136/bmjopen-2023-079063.
INTRODUCTION: Respiratory distress syndrome is a catastrophic respiratory problem among low birth weight neonates. It increases the suffering of neonates and the economic expenditure of the countries. Notably, it is a major public health issue in low-income and middle-income countries such as Ethiopia. Despite this, studies regarding respiratory distress syndrome among low birth weight neonates were limited in Ethiopia. OBJECTIVE: To assess the incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first 7 days in Northwest Ethiopia Comprehensive Specialized Hospitals. METHOD: Multicentred institution-based retrospective follow-up study was conducted from 19 September 2021 to 1 January 2023, among 423 low birthweight neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.6. and analysed using STATA V.14. The Kaplan-Meier failure curve and log-rank test were employed. Bivariable and multivariable Weibull regression was carried out to identify predictors of respiratory distress syndrome. Statistical significance was declared at a p≤0.05. RESULT: The incidence rate of respiratory distress syndrome was found to be 10.78 (95% CI 9.35 to 12.42) per 100 neonate days. Fifth minute Appearance, Pulse, Grimace, Activity, Respiration (APGAR score) <7 (AHR 1.86; 95% CI 1.18 to 2.92), multiple pregnancy (AHR 1.43; 95% CI 1.04 to 1.96), caesarean section delivery (AHR 0.62; 95% CI 0.41 to 0.93), prematurity (AHR 1.56; 95% CI 1.06 to 2.30) and birth weight <1000 g (AHR 3.14; 95% CI 1.81 to 5.40) and 1000-1499 g (AHR 2.06; 95% CI 1.42 to 2.83) were significant predictors. CONCLUSION: The incidence of respiratory distress syndrome was higher than other studies conducted on other groups of neonates. Multiple pregnancy, fifth minute APGAR score, caesarean section, prematurity, extremely low birth weight and very low birth weight were predictors of respiratory distress syndrome. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention for these predictors.
介绍：呼吸窘迫综合征是低出生体重儿的一种灾难性呼吸系统问题。它增加了新生儿的痛苦和国家的经济支出。值得注意的是，呼吸窘迫综合征是埃塞俄比亚等低收入和中等收入国家的一个主要公共卫生问题。尽管如此，关于低出生体重儿呼吸窘迫综合征的研究在埃塞俄比亚仍然有限。
目的：评估西北埃塞俄比亚综合专科医院低出生体重儿在出生后 7 天内呼吸窘迫综合征的发生率和预测因素。
方法：这是一项 2021 年 9 月 19 日至 2023 年 1 月 1 日进行的多中心基于机构的回顾性随访研究，共纳入 423 名低出生体重儿。采用简单随机抽样技术。数据使用新生儿病历的数据提取检查表收集。收集的数据输入 EPI-DATA V.4.6.0.6 并使用 STATA V.14 进行分析。采用 Kaplan-Meier 失败曲线和对数秩检验。进行单变量和多变量 Weibull 回归以确定呼吸窘迫综合征的预测因素。统计显著性定义为 p≤0.05。
结果：呼吸窘迫综合征的发生率为每 100 个新生儿日 10.78（95%CI 9.35 至 12.42）。第五分钟的外貌、脉搏、面部表情、活动、呼吸（APGAR 评分）<7（AHR 1.86；95%CI 1.18 至 2.92）、多胎妊娠（AHR 1.43；95%CI 1.04 至 1.96）、剖宫产分娩（AHR 0.62；95%CI 0.41 至 0.93）、早产（AHR 1.56；95%CI 1.06 至 2.30）和出生体重<1000g（AHR 3.14；95%CI 1.81 至 5.40）和 1000-1499g（AHR 2.06；95%CI 1.42 至 2.83）是显著的预测因素。
结论：呼吸窘迫综合征的发生率高于其他研究对其他组新生儿的研究。多胎妊娠、第五分钟 APGAR 评分、剖宫产、早产、极低出生体重和超低出生体重是呼吸窘迫综合征的预测因素。然而，这需要进一步的前瞻性研究。因此，相关利益相关者应该对这些预测因素给予应有的关注和适当的干预。
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