Frequency and Clinical Outcome of the Respiratory Tract Disease in Full-term Infant

ABSTRACT

PURPOSE: To investigate the frequency of underlying diseases associated with respiratory distress in full-term infants, as well as its relation to the mode of delivery and clinical outcomes. METHODS: We conducted a retrospective review of 4,264 infants who had been admitted to the neonatal intensive care unit (NICU) of Chonnam University Hospital (CUH) over 5 years from January 2000 to December 2004. Full-term infants with respiratory distress such as transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), congenital pneumonia, meconium aspiration syndrome (MAS) and pneumothorax were included. We analysed the incidence of underlying disease, its relation to the mode of delivery, rate of mechanical ventilator therapy, prevalence of hypoxic ischemic encephalopathy (HIE), mortality and the length of hospitalization of surviving patients. RESULTS: Of the 4,264 patients who admitted to the NICU of CUH over the last five years, preterm infants made up 2,278 (53.4%) and full-term infants made up 1,982 (46.5%). The number of full-term patients who admitted due to respiratory distress associated with respiratory system problems excluding a congenital anomaly was 246 (12.4%). The most common underlying disease was TTN (n=161, 65.4%), and the next was RDS (n=39, 15.9 %), congenital pneumonia (n=11, 4.5%), MAS (n=7.9, 8.5%), and pneumothorax (n=14, 5.7 %). RDS was more statistically common in full-term infants born by Caesarian section (P<0.05). But there was no difference according to the mode of delivery statistically in other respiratory tract diseases. The rate of mechanical ventilator therapy was significantly higher in RDS and MAS, and the prevalence of HIE was higher in MAS (P<0.05). Mortalities of RDS and MAS were 7.7% and 9.5% each. There was no significant difference in the length of hospitalization of surviving patients. CONCLUSION: TTN was the most common respiratory tract disease in the full-term infant, and RDS was more common in the infant who was born by Cesarean section. The rates of mechanical ventilator therapy and mortality were significantly higher in the infants with RDS and MAS, and HIE was exclusively manifested by infants with MAS.