Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants
Abstract 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...
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BMC
2024-10-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-024-05138-7 |
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| author | Jeongmin Shin Chang Won Choi Byung Kook Lee |
| author_facet | Jeongmin Shin Chang Won Choi Byung Kook Lee |
| author_sort | Jeongmin Shin |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-5a370ca42073454c8ff5a5c2c57f63d4 |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
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| series | BMC Pediatrics |
| spelling | doaj-art-5a370ca42073454c8ff5a5c2c57f63d42025-08-20T02:11:47ZengBMCBMC Pediatrics1471-24312024-10-012411910.1186/s12887-024-05138-7Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infantsJeongmin Shin0Chang Won Choi1Byung Kook Lee2Department of Pediatrics, Seoul St. Mary’s HospitalDepartment of Pediatrics, Seoul National University College of MedicineDepartment of Pediatrics, Chungnam National University Sejong HospitalAbstract 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.https://doi.org/10.1186/s12887-024-05138-7Respiratory distress syndromePregnancy-induced hypertensionPreeclampsiaSurfactantVery-low-birth-weight infant |
| spellingShingle | Jeongmin Shin Chang Won Choi Byung Kook Lee Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants BMC Pediatrics Respiratory distress syndrome Pregnancy-induced hypertension Preeclampsia Surfactant Very-low-birth-weight infant |
| title | Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants |
| title_full | Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants |
| title_fullStr | Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants |
| title_full_unstemmed | Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants |
| title_short | Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants |
| title_sort | risk factors for refractory respiratory distress syndrome among very low birth weight infants |
| topic | Respiratory distress syndrome Pregnancy-induced hypertension Preeclampsia Surfactant Very-low-birth-weight infant |
| url | https://doi.org/10.1186/s12887-024-05138-7 |
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