Clinical characteristics, diagnosis, and management outcome of surfactant deficiency respiratory distress syndrome in term and near-term neonates. A retrospective observational study.

Main Article Content

Sara Mohy Eldeen
Safaa Ali
Husam Salama

Keywords

term newborn, respiratory distress syndrome, surfactant, RDS,

Abstract

Aim: This study aims to describe the clinical characteristics of SRDS in term and late preterm neonates. Methods: This is an observation retrospective chart review of full-term and late preterm neonates born older than 35 to 41 weeks gestation age diagnosed with SRDS. The diagnosis was based on clinical & radiological manifestations of SRDS. Results: 1547 neonates were admitted during this period to NICU with a diagnosis of increased work of breathing for further management. 117 cases of term and near-term neonates (mean GA = 36.8 wks) had a confirmed diagnosis of Surfactant deficiency SRDS. Who compared 60 preterm neonates with SRDS less than 35 weeks gestation (mean GA 27.5 wks) as a control. The mean birth weight was 2.8 kg vs 1.1 kg in the preterm group. SRDS occurs more among the male gender (58%), with CS in 78.6 % of all diagnosed cases. No apparent cause was found in 28.2 %, while 37.6% of all cases were born to mothers with diabetes mellitus, and 27% were born to mothers with either GBs infection, maternal chorioamnionitis, or prolonged rupture of the membrane. Conclusion: SRDS is not uncommon among full-term and near-term neonates (10/1000 live birth). By far, the most common associated risk factors are maternal diabetes mellitus and cesarean section. It affects males more than females. Most cases will run a mild-to-moderate course that responds to non-invasive ventilation.

Downloads

Download data is not yet available.
Abstract 136 | PDF Downloads 102

References

1. Salama H, Abughalwa M, Taha S, Sharaf N, Mansour A. Transient tachypnea of the newborn: Is Empiric antimicrobial therapy needed? Journal of Neonatal-Perinatal Medicine. 2013;6(3):237–41. DOI: 10.3233/NPM-1367012
2. Avery ME, Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. AMA Journal of Diseases of Children [Internet]. 1959 May 1 [cited 2022 Sep 23];97(5, Part 1):517–23.
3. Chen A, Shi L, Zheng J, Du L. [Clinical characteristics and outcomes of respiratory distress syndrome in term and late-preterm neonates]. Zhonghua er ke za zhi = Chinese journal of pediatrics [Internet]. 2008 Sep 1 [cited 2022 Oct 23];46(9):654–7.
4. Liu J, Shi Y, Dong J-Y, Zheng T, Li J-Y, Lu L-L, et al. Clinical characteristics, diagnosis and management of respiratory distress syndrome in full-term neonates. Chin Med J (Engl). 2010;123(19):2640–4
5. Yuksel B, Greenough A. Neonatal respiratory distress and lung function at follow-up. Respiratory Medicine. 1991 May;85(3):235–7.
6. Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ. 2007 Dec 11;336(7635):85–7. DOI: 10.1136/bmj.39405.539282.BE.
7. Robinson CJ, Villers MS, Johnson DD, Simpson KN. Timing of elective repeat cesarean delivery at term and neonatal outcomes: a cost analysis. American Journal of Obstetrics & Gynecology . 2010 Jun 1 [cited 2021 Apr 30];202(6):632.e1–6. DOI: 10.1016/j.ajog.2010.03.045.
8. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med [Internet]. 1994;149(3 Pt 1):818–24. Available from: http://doi.org/10.1164/ajrccm.149.3.7509706
9. Nkadi PO, Merritt TA, Pillers D-AM. An overview of pulmonary surfactant in the neonate: genetics, metabolism, and the role of surfactant in health and disease. Mol Genet Metab [Internet]. 2009;97(2):95–101. Available from: http://dx.doi.org/10.1016/j.ymgme.2009.01.015
10. Hamvas A, Cole FS, Nogee LM. Genetic disorders of surfactant proteins. Neonatology [Internet]. 2007;91(4):311–7. http://dx.doi.org/10.1159/000101347
11. Hansen T, Corbet A. Disorders of the transition. In: Ballard RA, Avery ME, editors. Diseases of the neonates. 1991. p. 498–504.
12. Downes JJ, Vidyasagar D, Morrow GM, Boggs TR. Respiratory distress syndrome of newborn infants: I. New clinical scoring system (RDS score) with acid-base and blood-gas correlations. Clin Pediatr (Phila) [Internet]. 1970;9(6):325–31. http://dx.doi.org/10.1177/000992287000900607
13. Vidyasagar D, Velaphi S, Bhat VB. Surfactant replacement therapy in developing countries. Neonatology [Internet]. 2011;99(4):355–66. http://dx.doi.org/10.1159/000326628
14. Shashidhar, Pn SR, Jose J. Downes score vs Silverman Anderson score for assessment of respiratory distress in preterm newborns. Pediatr Oncall [Internet]. 2016;13(3). http://dx.doi.org/10.7199/ped.oncall.2016.30
15. Weaver TE, Jobe AH. Fetal Neonatal Lung Dev Clin Correl Technol Futur. Published online [Internet]. 2016:141–63. http://dx.doi.org/10.1017/9781139680349.009
16. Cleveland RH. A radiologic update on medical diseases of the newborn chest. Pediatr Radiol. 1995;25(8):631-7. doi: 10.1007/BF02011835. PMID: 8570317.
17. Bouziri A, Ben Slima S, Hamdi A, Menif K, Belhadj S, Khaldi A, Kechaou W, Kazdaghli K, Ben Jaballah N. Le syndrome de détresse respiratoire aigue du nouveau-né à terme et proche du terme: à propos de 23 observations (Acute respiratory distress syndrome in infants at term and near term about 23 cases). Tunis Med. 2007 Oct;85(10):874-9. French. PMID: 18236812.
18. Faix RG, Viscardi RM, DiPietro MA, Nicks JJ. Adult respiratory distress syndrome in full-term newborns. Pediatrics [Internet]. 1989;83(6):971–6. Available from: http://dx.doi.org/10.1542/peds.83.6.971
19. Ramaswamy VV, Abiramalatha T, Bandyopadhyay T, Boyle E, Roehr CC. Surfactant therapy in late preterm and term neonates with respiratory distress syndrome: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed [Internet]. 2022;107(4):393–7. Available from: http://dx.doi.org/10.1136/archdischild-2021-322890
20. Golombek SG, Truog WE. Effects of surfactant treatment on gas exchange and clinical course in near-term newborns with RDS. J Perinat Med [Internet]. 2000;28(6):436–42. Available from: http://dx.doi.org/10.1515/JPM.2000.058
21. Sun H, Xu F, Xiong H, et al. Characteristics of respiratory distress syndrome in infants of different gestational ages. Lung. 2013;191(4):425-433. doi:10.1007/s00408-013-9475-3