Respiratory distress, associated risk factors and early outcome among neonates admitted at Muhimbili medical centre, Dar es Salaam.

Abstract

Respiratory distress is the most frequent life threatening morbidity to occur in the neonate. A prospective unmatched case control study on respiratory distress, associated risk factors and early outcome among neonates admitted at MMC was carried out for 8 months from March to November 1995. 648 neonates w~re studied, 328 of these were cases and 320 were controls. Respiratory distress contributed to 7.6 % of all the neonatal admissions. Overall, respiratory distress contributed to 18.7 % of all the neonatal deaths during the study period. The mortality rate among neonates with respiratory distress was 45.4 % . 6% of all the neonatal admissions were due to Respiratory distress syndrome (RDS). Neonates with RDS had significantly lower birth weights and gestational age compared with the controls. Birth asphyxia increased significantly the proportion of neonates with RDS. EPH gestosis significantly lowered the proportion of neonates with RDS. The frequency of RDS in males was significantly higher than in females. There was no significant association between RDS and mode of delivery, antepartum haemorrhage or premature rupture of membranes of more than 24 hours. Expiratory grunting was significantly associated with increased mortality among RDS cases. Pneumonia in the first week of life contributed to 1.5 % of all the neonatal admissions during the study. Meconium stained liquor was significantly associated with increased frequency of pneumonia in the first week of life. However, there was no significant association between pneumonia occuring in the first week of life and premature rupture of membranes, prolonged labour or birth asphyxia. Since RDS which is more or less confined to the preterm infant was the commonest disorder • causing respiratory distress in the newborn, it should be possible to reduce its incidence by measures aimed at preventing premature delivery.