Lung

, Volume 191, Issue 4, pp 425–433

Characteristics of Respiratory Distress Syndrome in Infants of Different Gestational Ages

  • Huiqing Sun
  • Falin Xu
  • Hong Xiong
  • Wenqing Kang
  • Qiongdan Bai
  • Yinghui Zhang
  • Chongchen Zhou
  • Fangli Zhuang
  • Xiaoyang Wang
  • Changlian Zhu
Article

DOI: 10.1007/s00408-013-9475-3

Cite this article as:
Sun, H., Xu, F., Xiong, H. et al. Lung (2013) 191: 425. doi:10.1007/s00408-013-9475-3

Abstract

Background

The purpose of this study was to compare the risk factors, clinical characteristics, and complications of respiratory distress syndrome (RDS) in infants delivered very preterm, late preterm, and term in order to help optimize the management of RDS in neonates.

Methods

A retrospective study was conducted on neonates admitted to the NICU between January 2006 and December 2010. The enrolled infants with RDS were categorized as very preterm (<320/7 weeks gestation), moderately preterm (320/7–336/7 weeks), late preterm (340/7–366/7 weeks), and term (370/7–420/7 weeks). The rates, potential risk factors, clinical characteristics, and complications of RDS of these four groups were comparatively analyzed.

Results

There was an increasing trend in incidence of RDS among the NICU admissions annually. Caesarean section without labor was significantly associated with RDS in term and late preterm infants (P < 0.001). Rates of requirements for ventilator and pulmonary surfactant were similar in very preterm and term infants but significantly lower in late preterm infants (P < 0.001). The oxygenation index value was not substantially lower in late preterm and term infants compared to very preterm infants, and the arterial oxygenation efficiency was improved slowly (P < 0.001). Incidence of pneumonia and occurrence of pneumothorax were significantly higher in term infants (P < 0.001).

Conclusions

Term infants with RDS showed an association of RDS with caesarean section without labor and lung infection. These infants also showed slower improvement of oxygenation after surfactant administration and mechanical ventilation, and they experienced a high rate of pneumothorax complication, which was also noticed in late preterm neonates.

Keywords

Respiratory distress syndromePreterm infantsTerm infantsCaesarean sectionLung infection

Abbreviations

BPD

Bronchopulmonary dysplasia

CMV

Conventional mechanical ventilation

CPAP

Continuous positive airway pressure

CRP

C-reactive protein

FIO2

Fraction of inspiration oxygen

INSURE

Intubation-surfactant-extubation

IVH

Intraventricular hemorrhage

MAP

Mean airway pressure

MOSF

Multiple organ system failure

NEC

Necrotizing enterocolitis

NICU

Neonatal intensive care unit

OI

Oxygenation index

PaO2

Partial arterial oxygen pressure

PS

Pulmonary surfactant

RDS

Respiratory distress syndrome

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Huiqing Sun
    • 1
    • 2
  • Falin Xu
    • 1
  • Hong Xiong
    • 2
  • Wenqing Kang
    • 2
  • Qiongdan Bai
    • 1
  • Yinghui Zhang
    • 2
  • Chongchen Zhou
    • 2
  • Fangli Zhuang
    • 1
  • Xiaoyang Wang
    • 1
    • 3
    • 4
  • Changlian Zhu
    • 1
    • 3
    • 5
  1. 1.Department of PediatricsThe Third Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  2. 2.Department of PediatricsZhengzhou Children’s HospitalZhengzhouChina
  3. 3.Henan Key Laboratory for Neonatal Brain InjuryZhengzhouChina
  4. 4.Perinatal Center, Sahlgrenska AcademyUniversity of GothenburgGöteborgSweden
  5. 5.Center for Brain Repair and Rehabilitation, Institute of Neuroscience and PhysiologyUniversity of GothenburgGöteborgSweden