DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20171252

Determinants of outcome in newborns with respiratory distress in Osogbo, Nigeria

Olusegun J. Adebami, Victor I. Joel-Medewase, Efeturi Agelebe, Temitope O. Ayeni, Olamide V. Kayode, Ololade A. Odeyemi, Gabriel A. Oyedeji

Abstract


Background: Respiratory distress is one of the commonest presentations necessitating hospital admission in newborn unit. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to apnoea, respiratory failure, cardiopulmonary arrest and death.

Methods: A cross-sectional and descriptive study of newborns with respiratory distress admitted into the SCBU of LAUTECH Teaching Hospital, Osogbo, Nigeria. Respiratory distress was diagnosed by grunting, inspiratory stridor, nasal flaring and tachypnea (more than 60 breaths per minute), retractions in the intercostal, subcostal, or supracostal spaces and cyanosis. At admission, every neonate had a complete physical examination.

Results: Of 625 babies admitted, 384 (61.4%) were males while 241 (38.6%) were females and 164 (26.2%) had respiratory distress. Respiratory distress was commoner among the preterms than term newborns. c2 = 44.7, p = 0.001. Leading causes of respiratory distress among the preterms were hyaline membrane disease, septicaemia, while among the term babies were perinatal asphyxia, transient tachypnoea of newborn and meconium aspiration. Sixty (36.6%) of the 164 babies with respiratory distress died. While 40.2% of the preterms died mainly from causes like hyaline membrane disease and septicaemia, 31.3% of term babies died from causes like perinatal asphyxia and meconium aspiration. Mortality from hyaline membrane disease was 46.9%, while perinatal asphyxia and meconium aspiration accounted for 38.9% and 40.0% respectively.

Conclusions: Respiratory distress is therefore, a very common neonatal problem and it causes death of more than third of those affected. Emphasis should be geared towards reduction of preterm delivery, control of asphyxia and neonatal sepsis in order to reduce neonatal mortality in our environment.


Keywords


Hyaline membrane disease, Neonatal respiratory distress, Nigeria, Perinatal asphyxia

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References


Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr Respir Rev. 2013;14(1):29-36.

Hibbard JU, Wilkins I, Sun L, Gregory K, Haberman S, Hoffman M, et al. Consortium on Safe Labor. Respiratory morbidity in late preterm births. JAMA. 2010;304(4):419-25

Reuter S, Moser C, Baack M. Respiratory Distress in the Newborn. Pediatr Rev. 2014;35(10):417-29.

World Health organization. Hypoglycaemia of the newborn. Review of the literature In: World Health Organization Division of Child Health and development and maternal and newborn helath/Safe motherhood bulletin. WHO/CHD/97.1 1997;52576:6-45.

Lincetto O. Birth Asphyxia - Summary of the previous meeting and protocol overview WHO Geneva 2007_birth_asphyxia02.

Bajad M, Goyal S, Jain B. Clinical profile of neonates with respiratory distress. International Journal of Contemporary Pediatrics. 2016;3(3):1009-13.

Abdelrahman SMK, Hamed SMA, Nasr A. Neonatalrespiratory distress in Omdurman Maternity Hospital, Sudan. Sudan J Paediatr. 2014;14(1):65-70.

Fedakar A, Aydoğdu C. Clinical Features of neonates treated in the intensive Care Unit for Respiratory distress. Turk J Ped. 2011;53:173-9.

Kumar A, Vishnu Bhat, B. Epidemiology of respiratory distress of newborns. Indian J Pediatr. 1996;63:93-8.

Hjalmarson O. Epidemiology and classification of acute neonatal respiratory disorders. Acta Pediatr Scand. 1981;70:773-83.

Wynn JL, Levy O. Role of innate host defences in susceptibility to Early- onset neonatal sepsis. Clin Perinatol. 2010;37(2)307-37.

Reuter S, Moser C, Baack M. Respiratory Distress in the Newborn. Paediatr Rev. 2014;35(10):417-29

Weisman LE, Hansen TN. Contemporary Diagnosis and Management of Neonatal Respiratory Diseases. 3rd ed. Newton, PA: Handbooks in Health Care Co.; 2003

Adebami OJ. Maternal and fetal determinants of mortality in babies with birth asphyxia at Osogbo, Southwestern Nigeria. Glo Adv Res J Med Med Sci. 2015;4(6):270-6.

Adebami OJ, Joel-Medewase VI, Oyedeji GA. Clinico laboratory determinants of outcome among babies with perinatal asphyxia in Osogbo, Southwestern Nigeria. Int J Contemp Pediatr. 2016;3(2):409-15

Adebami OJ, Joel-Medewase VI, Oyedeji OA, Oyedeji GA. A review of neonatal admissions in Osogbo, Southwestern Nigeria. Nig Hosp Pract. 2010;5:36-41.

World health organization. Basic Newborn Resuscitation Guidelines. http:www.who.int/ maternal-child-adloscent/ en. [Last accessed on 2015 September 28].

Babu ABV, Devi SS, Kumar KB. Birth asphyxia – Incidence and immediate outcome in relation to risk factors and complications. Int J Res Hlth Sci. 2014;2(4):1064-71.