Acute respiratory morbidity in late preterm infants
- Simonetta Picone1Email author,
- Roberto Aufieri1 and
- Piermichele Paolillo1
https://doi.org/10.1186/1824-7288-40-S2-A34
© Picone et al; licensee BioMed Central Ltd. 2014
Published: 9 October 2014
Keywords
Background
Late preterm (LP) infants [gestational age (GA): 34-36 weeks] are at increased risk of neonatal acute respiratory morbidity compared with term infants (GA: 37- 41)[1, 2]. The observed rate of acute respiratory morbidity, in a population of about 20,000 LP infants, was 10-12% vs 1.4% of term infants [1]. Transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) are the most common diagnosis, with RDS rate reaching 10.5% in infants born at 34 weeks of GA [1, 2]. Major causes of respiratory morbidity in LP are: prematurity and birth by Cesarean Section (CS) [1, 3].
Material and methods
We retrospectively studied 830 LP and moderate preterm (MP) infants (GA: 33-36 weeks) admitted to our unit from June 2009 to December 2013. Infants were classified according to GA: 33 weeks (n=129), 34 weeks (n=176), 35 weeks (n=225), 36 weeks (n=300). Clinical charts for each patient were reviewed and main diagnosis recorded.
Results
Acute respiratory morbidity in LP/MP infants (n= 830)
GAa (weeks) | |||||
---|---|---|---|---|---|
33 | 34 | 35 | 36 | TOT | |
n | 129 | 176 | 225 | 300 | 830 |
Respiratory morbidity | 60 (46.5) | 53 (30.1) | 42 (18.7) | 59 (19.7) | 214 (25.8) |
TTN b n (%) | 14 (10.9) | 15 (8.5) | 16 (7.1) | 30 (10.0) | 75 (9.0) |
RF c n (%) | 31(24.0) | 14 (8.0) | 12 (5.3) | 8 (2.7) | 65 (7.8) |
RDS d n (%) | 12 (9.3) | 24 (13.6) | 12 (5.3) | 14 (4.7) | 62 (7.5) |
PNX e n (%) | 1 (0.8) | - | 8 (3.5) | 7 (2.3) | 16 (1.9) |
Pneumonia n (%) | 1 (0.8) | 3 (1.7) | 1 (0.4) | 8 (2.7) | 13 (1.6) |
AOP f n (%) | 3 (2.3) | - | - | 2 (0.7) | 5 (0.6) |
PPH g n (%) | - | 1 (0.6) | 1 (0.4) | - | 2 (0.2) |
MAS h n (%) | - | - | - | - | - |
Infection in infants with RDS n (%) | 3 (25.0) | 9 (37.5) | 6 (50.0) | 9* (64.3) | 27* (43.5) |
Infection in infants with other respiratory morbidity n (%) | 8 (16.7) | 10 (34.5) | 11 (39.7) | 14* (31.1) | 43* (28.3) |
Conclusions
Acute respiratory morbidity in our unit affects a quarter of LP/MP infants. An important percentage (7.5%) is represented by RDS, that is often associated with infection. Infants born at 34 weeks of GA are the population at higher risk of RDS. Even if rate and severity of acute respiratory morbidity in LP are already described by a number of epidemiological studies, further investigation is needed to better clarify the optimal timing and dose of surfactant administration and to correlate different strategies of respiratory management with long-term respiratory and neurological outcomes. The high infection rate found among infants with RDS and acute respiratory morbidity, emphasizes the importance of a prompt diagnosis and treatment of chorioamnionitis and perinatal infections.
Authors’ Affiliations
References
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Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.