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Respiratory distress in term newborns: Can we predict the outcome?

Authors:

Nimesha Chamidani Gamhewage ,

University of Sri Jayewardenepura, Sri Lanka, LK
About Nimesha
University of Sri Jayewardenepura, Sri Lanka
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Hemali Jayakodi,

Regional Director of Health Services, Anuradhapura, Sri Lanka, LK
About Hemali
Regional Director of Health Services, Anuradhapura, Sri Lanka
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Janaki Samarakoon,

Castle Street Hospital for Women, Colombo, Sri Lanka, LK
About Janaki

Castle Street Hospital for Women, Colombo, Sri Lanka

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Sajini de Silva,

Castle Street Hospital for Women, Colombo, Sri Lanka, LK
About Sajini
Castle Street Hospital for Women, Colombo, Sri Lanka
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LPC Saman Kumara

Castle Street Hospital for Women, Colombo, Sri Lanka
About LPC
Castle Street Hospital for Women, Colombo, Sri Lanka
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Abstract

Introduction: Respiratory distress in term newborns is due to a variety of causes and nearly seven percent of term babies develop respiratory distress during the early neonatal period. Numerous challenges are faced by clinicians working in resource poor settings, when deciding on resource allocation and transfer to other units, as it is difficult to predict the babies who might later need advanced respiratory support. 

Objectives: To determine the incidence and aetiology of early onset respiratory distress in term babies and to identify predictors of congenital pneumonia, need for ventilation and mortality.

Method: A prospective descriptive cross sectional study was conducted at Castle Street Hospital for Women on 200 term babies developing respiratory distress within the first 2 hours of birth. One minute Apgar score, Silverman score, birth weight and details regarding management were recorded.

Results: Incidence of early onset respiratory distress was 8.2%, the commonest aetiologies being transient tachypnoea of newborn, congenital pneumonia and meconium aspiration syndrome. Silverman score of more than 5 on first assessment, birth weight, presence of risk factors for sepsis and low Apgar score were associated with the need for invasive ventilation, while low Apgar score was a predictor for mortality. High Silverman score and presence of risk factors for early onset neonatal sepsis were associated with congenital pneumonia.

Conclusions: Among term babies born at Castle Street Hospital for Women, the incidence of RD within first 2 hours of birth was 8.2%, the common aetiologies being TTN, congenital pneumonia and MAS. While Silverman score more than 5 on first assessment and low first minute Apgar were strongly predictive of the need for invasive ventilation, low first minute Apgar score was a predictor for mortality.
How to Cite: Gamhewage, N.C., Jayakodi, H., Samarakoon, J., de Silva, S. and Saman Kumara, L., 2020. Respiratory distress in term newborns: Can we predict the outcome?. Sri Lanka Journal of Child Health, 49(1), pp.30–34. DOI: http://doi.org/10.4038/sljch.v49i1.8895
Published on 05 Mar 2020.
Peer Reviewed

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