Analysis Of Neonatal Respiratory Distress Syndrome Among Different Gestational Segments

Neonatal respiratory distress syndrome is a serious disease leading to early death in premature infants which is caused by lack of pulmonary surfactant (PS) or with the structure immaturity, more common in preterm children. This disease has more complications, high mortality, survivors may be left behind serious lung or eyes, nervous system sequelae. In recent years, with the increasing of cesarean section rate, (near) full-term infants have significantly higher rates of occurrence of RDS in infants with RDS,which accounted for nearly 1/3, especially more common in elective cesarean section infants. The analysis at different gestational ages about the comparison of NRDS risk factors, treatment and prognosis, timely diagnosis and prevention is important. This paper selected neonatal met the study criteria in January 2008-December 2010 in The First Hospital of Jilin University,who were admitted NRDS infants.According to the gestational age,these infants were divided into three groups:term-baby-group 86 cases, late preterm-grop 36 cases, early-preterm-group 110 cases. Retrospective analysis of data and history of each case to establish a single questionnaire, and statistical analysis the following factors:the situation during pregnancy, perinatal factors, combined disease status, treatment of respiratory distress syndrome and complications, prognosis and so on. The main factors included:1,the situation during pregnancy and perinatal:maternal age; mode of delivery; whether rupture of membranes; chronic hypoxia history (the mother abnormalities, umbilical cord or placenta abnormalities); whether there is fetal distress performance; whether the meconium-stained or amniotic fluid aspiration; birth weight; gender, Apgars'score.2, clinical feartuers:chest-X ray,comorbidities:pulmonary infection; air leak; newborn persistent pulmonary hypertension(PPHN), patent ductus arteriosus(PDA), intracranial hemorrhage(IVH); heart failure; prognosis. The results showed that:There were significant differences in 11 factors,which were cesarean section, premature rupture of membranes, history of chronic hypoxia, umbilical cord abnormalities, asphyxia, the number of application PS cases, weaning time after non-invasive respiratory support, air leak, PPHN, PDA, IVH.3, the treatment process:whether the application of surfactant; time for application of PS; the number of application cases of invasive mechanical ventilation and the lasting time, non-invasive respiratory support time.Pathogenetic condition:Full-term and late preterm infants accounted for more than 50% of the total NRDS; full-term infants were mainly less than 39 weeks, accounting for 83.7%; advanced maternal age in preterm infants> 30 were more common, accounting for 61.1%; The incidence rate of cesarean section were higher in each group, especially the full-term and late preterm groups, respectively 90.7%,86.1%;②Clinical features:full-term infants might be late onset, more than 12 hours;The chest X-ray change in early preterm neonates was more common with air bronchogram, but rare in other two groups; The incidence of lung infection in each group was about 50%. In addition, for full-term anad late-preterm infants, the more common complication were the gas leak and PPHN, while for the preterm infants were bronchopulmonary dysplasia and intracranial hemorrhage③Treatment:The proportions of application of HFOV and NO for full-term infants were 57.0%,24.4%; for late-preterm ones were 36.1%,22.2%, while for the early preterm infants the proportions were relatively less; In the three groups the duration of invasive ventilation was no significant difference, but for early preterm infants, noninvasive ventilation after extubation longer required to 10.1±0.5 days; The proportion of PS in the three groups respectively were 53.5%,83.3% and 81.8%; As for the change of OI values after application of PS:it was improved significantly after 2h for the early preterm infants,while for full-term and late preterm ones, the obvious difference was found only after 24h.In summary concluded that:①Besides early preterm infants, neonates in full-term and late preterm have the growing trend in the pathogenesis of NRDS;②nfants in different gestational age have their own characteristics about the risk factors, cesarean section accounted for a major role for the incidence of term and late preterm infants.③The cliniacl feature,chest X-ray change and common complications were characteristic between term and premature infants with NRDS.④The term and late preterm infants slow onset for application of PS,for whom the application of HFOV and NO were more common.