Περίληψη:
Background Neonatal respiratory distress syndrome (NRDS) is strongly
associated with premature birth, but it can also affect term neonates.
Unlike the extent of research in preterm neonates, risk factors
associated with incidence and severity of NRDS in term neonates are not
well studied. In this study, we examined the association of maternal and
neonatal risk factors with the incidence and severity of NRDS in term
neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus.
Methods In a prospective, case-control design we recruited term neonates
with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III
hospital, the only neonatal tertiary centre in Cyprus, between April
2017-October 2018. Clinical data were obtained from patients’ files. We
used univariate and multivariate logistic and linear regression models
to analyse binary and continuous outcomes respectively. Results During
the 18-month study period, 134 term neonates admitted to NICU were
recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as
controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95%
CI: 1.03-18.39, p = 0.045) and elective caesarean section (OR: 11.92,
95% CI: 1.80-78.95, p = 0.01) were identified as independent predictors
of NRDS. Among neonates with NRDS, early-onset infection tended to be
associated with increased administration of surfactant (beta:0.75, 95%
CI: - 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or
systemic hypotension were associated with longer duration of parenteral
nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic
hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion
(pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension:
85% Vs 55%, p = 0.013). Conclusions This study highlights the role of
elective caesarean section and male gender as independent risk factors
for NRDS in term neonates. Certain therapeutic interventions are
associated with complications during the course of disease. These
findings can inform the development of evidence-based recommendations
for improved perinatal care.
Συγγραφείς:
Stylianou-Riga, Paraskevi
Boutsikou, Theodora
Kouis, Panayiotis
and Kinni, Paraskevi
Krokou, Marina
Ioannou, Andriani and
Siahanidou, Tania
Iliodromiti, Zoi
Papadouri, Thalia and
Yiallouros, Panayiotis K.
Iacovidou, Nicoletta
