Clinical Analysis Of Neonatal Respiratory Distress Syndrome From 2002 To 2011

Objective:Respiratory distress syndrome, RDS, due to its high mortality, is the most common respiratory disease in the neonatal intensive care unit, NICU. RDS is used to be known on the top list of cause of death in premature baby. In the currently reports, the incidence of full-term infants in neonatal respiratory distress syndrome, NRDS, have been significantly rising. Comparing to preterm baby, full-term baby had higher rate of complications and took longer in average assisted ventilation time; therefore, NRDS in the full-term baby has become the hotspot of the research. In this study, by collecting perinatal conditions, clinical manifestations, nutritional status, usage of pulmonary surfactant and oxygen, recovery, and medical expenses of past 10 years of RDS cases in the Children’s Hospital of Fudan University, retrospective analysis of the dynamic changes of the past 10 years in children with RDS is used to gathering local data for China Neonatal Network, and it can be used to provide national current status and basis of RDS, clinical guideline, and early preventive interventions to reduce the incidence of RDS.Method:Retrospectively analyzed 1349 NICU cases of neonatal respiratory distress syndrome cases in the Children Hospital of Fudan University from January 1st,2002 to December 31th,2011. The data was statistically analyzed and dynamically observed in groups per annum, according to gestational age, birth weight grouping, general status, perinatal, clinical manifestations, usage of pulmonary surfactant and oxygen, prognosis and medical expenses.Result:From 2002 to 2011, admitted neonatal respiratory distress syndrome in the number of cases increased in year by year, and at the same period of time, the ratio had been taken in NICU patients showing an upward trend in 0.92%,1.78%,2.40%, 3.26%,3.40%,5.24%,6.13%,4.29%,5.81%,5.34%. Male was predominant,64.3%, in the 1349 cases, and gestational age between 37 to 38+6weeks had been proportionally increased yearly. Cesarean section birth ratio was increasing, the greater the gestational age, the higher the proportion of cesarean section, and the difference was statistically significant (P<0.05). However, no upward trend in prenatal steroid during maternal, there is no statistically significant difference. Mother with pregnancy-induced hypertension, fetal distress, premature rupture of membranes and multiple births were linked to RDS, and the difference was statistically significant (P<0.05). The main clinical symptoms were respiratory distress, poor response and bruise. Late preterm infants and full-term babies had higher incidence of PPHN and pneumothorax than early preterm infants, and full-term babies had higher chance of PDA than premature babies; the differences were statistically significant (P<0.05). The PPHN and PDA incidences had statistically significant (P<0.05) in increasing annually. In treatment, the shorter gestational age caused the longer days of CPAP uses. Full-term infants and RDS babies with gestational age less than 28 weeks had higher ratio and longer days of using CVM and HFOV. Also, full-term RDS infants had higher proportion of NO usage than premature RDS babies, and the difference has statistically significant (P<0.05). In prognosis, the overall mortality of RDS decreased per year, and the difference had statistically significant (P<0.05).Conclusion:1.,The occurrence rate of Neonatal respiratory distress syndrome (RDS) appears to be increasing,89.8% are premature infants. Infants with gestational age of 28-31+6 weeks and a birth weight between 1000-1499g are in the high risk population.2. Tthe use of glucocorticosteroids before delivery and the use of PS after delivery is yet to be increased.3. Tthe occurrence rate of RDS in full term infants delivered through cesarean section is gradually increasing, hence the necessity of cesarean section should be carefully evaluated.4. RDS in full term infants has a higher rate of complications and a longer use of supported ventilation. RDS in full term infants also has a higher fatality rate comparing with premature infants with RDS.5. Tthe fatality rate of RDS has drastically decreased in 10 years.