Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants.

Autor: Shin J; Department of Pediatrics, Seoul St. Mary's Hospital, Seoul, 06591, Republic of Korea., Choi CW; Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea. choicw1029@gmail.com.; Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Koreas, 13620, Republic of Korea. choicw1029@gmail.com., Lee BK; Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, 30099, Republic of Korea.
Jazyk: angličtina
Zdroj: BMC pediatrics [BMC Pediatr] 2024 Oct 24; Vol. 24 (1), pp. 677. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1186/s12887-024-05138-7
Abstrakt: Background: The objective was to evaluate refractory respiratory distress syndrome (RDS) risk factors among very-low-birth-weight infants (VLBWIs).
Method: The data of VLBWIs born between January 2013 and December 2020 registered in the Korean Neonatal Network (KNN) were analyzed. Infants who died within 5 postnatal days or who were not given surfactant were excluded. Infants were divided into a well-responding RDS group, which received surfactant replacement therapy (SRT) only once, and a refractory RDS group, which received SRT twice or more. The associations between perinatal characteristics and refractory RDS were investigated via multivariate logistic regression analysis.
Results: Multivariate logistic regression analysis revealed that low gestational age (adjusted odds ratio [aOR] = 1.26, 95% confidence interval (CI) [1.23, 1.26], male sex (aOR = 1.17, 95% CI [1.06, 1.29]), cesarean section (aOR = 1.59, 95% CI [1.38, 1.80]), maternal hypertensive disorder (aOR = 1.54, 95% CI[1.35, 1.75]), and low 5-minute Apgar scores (aOR = 1.24, 95% CI [1.12, 1.37]) were significantly associated with refractory RDS. Antenatal corticosteroid use (aOR = 0.81, 95% CI [0.73, 0.89]) and maternal chorioamnionitis (aOR = 0.79, 95% CI [0.71, 0.88]) were significantly inversely associated with refractory RDS. Compared with well-responding RDS, refractory RDS was significantly associated with increased major neonatal morbidity and mortality risk at 5 postnatal days.
Conclusion: Maternal hypertensive disorder is a significant risk factor for refractory RDS. Refractory RDS was associated with unfavorable neonatal outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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