Frequency, Etiology, and Outcomes of Respiratory Distress in Term and Preterm Neonates Admitted to a Tertiary Care NICU.
DOI:
https://doi.org/10.63682/jns.v14i33S.10059Keywords:
Physiology, Neonatal Respiratory Distress Syndrome (NRDS), Transient Tachypnea of the Newborn (TTN), Meconium Aspiration Syndrome (MAS), Public HealthAbstract
Background: Neonatal respiratory distress (NRD) remains a major cause of neonatal morbidity and mortality, especially in low- and middle-income countries. This study aimed to determine the frequency, etiological distribution, and outcomes of term and preterm neonates presenting with respiratory distress in a tertiary NICU.
Methods: A descriptive prospective study was conducted over six months in the NICU of Shifa International Hospital, Islamabad. A total of 160 neonates with clinical signs of respiratory distress were enrolled via consecutive sampling. Exclusion criteria included congenital lung anomalies and major cardiac malformations. Gestational age, clinical features, investigations, etiology, respiratory support details, and outcomes were recorded. Data were analyzed using SPSS v20. Associations were tested using Chi-square; a p ≤ 0.05 was considered significant.
Results: Among 160 neonates, 91 (56.9%) were preterm. The most common etiologies of respiratory distress were respiratory distress syndrome (RDS) (22.5%), neonatal sepsis (21.9%), congenital pneumonia (19.4%), transient tachypnea of the newborn (TTN) (18.1%), and meconium aspiration syndrome (MAS) (18.1%). Overall mortality was 63.8%, significantly higher in preterm neonates (p < 0.01). Male gender and low birth weight were associated with increased risk of severe distress and adverse outcomes. Early respiratory support modalities varied from nasal oxygen to mechanical ventilation.
Conclusion: RDS, sepsis, and pneumonia remain leading causes of NRD, with high mortality in preterm infants. Enhanced perinatal care, early diagnosis, and optimized respiratory support strategies are essential to improve outcomes in tertiary NICU settings.
Downloads
References
[1] Afroze S, Rahman T, Mallik T, Rima SA, Pandita A, Shahidullah M. Outcome of neonates with respiratory distress in a tertiary center NICU of Bangladesh: a prospective study. Bangladesh J Med Sci. 2024;23(3):812–817.
[2] Yeasmin N, Khanam W, Parvin R, Adnan MA, Hossain MI, Mondal MT, et al. Risk factors, causes and hospital outcome of respiratory distress among neonates admitted in neonatal intensive care unit. Int J Contemp Pediatr. 2023;10(5):627–632.
[3] Dominguez G, Muralidharan O, Lee H, Smith J, Patel A. Care of preterm and term newborns with respiratory conditions: a systematic synthesis of evidence from low- and middle-income countries. Neonatology. 2024;122(2):152–172.
[4] Koti J, Murki S, Gaddam P, Reddy A, Reddy M. Non-invasive respiratory support strategies for neonatal respiratory distress in low-resource settings: a multicenter cohort study. BMC Pediatr. 2023;23:418.
[5] Li X, Zhang Y, Chen C, Wang L, Liu H. Clinical management and outcomes of respiratory distress syndrome in preterm infants: data from a national neonatal network. Pediatr Pulmonol. 2023;58(11):3421–3430.
[6] Himayat M, Arif M, Iftikhar H, Khan S, Javed N. Frequency and determinants of respiratory distress among neonates admitted to intensive care unit. J Health Wellness Community Res. 2025;3(6):e358.
[7] Hanif MI, Ahmed F, Ali SR, Raza SJ. Clinical outcomes of neonatal admissions with respiratory distress at a tertiary care hospital. Pak Pediatr J. 2024;48(1):15–21.
[8] Afroze F, Rahman MA, Karim MR, Hossain MM, Chowdhury S. Etiology and short-term outcome of neonatal respiratory distress in term and late preterm infants. J Perinatol. 2024;44(2):245–252.
[9] Alemu A, Desta T, Worku T, Tadesse M. Predictors of neonatal respiratory distress: a case-control study from Ethiopia. BMC Pediatr. 2024;24:96.
[10] Singh N, Kumar R, Meena R, Gupta A. Clinico-epidemiological profile and outcomes of neonatal respiratory distress in a tertiary NICU. Int J Contemp Pediatr. 2024;11(1):34–40.
[11] Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, te Pas A, et al. European consensus guidelines on the management of respiratory distress syndrome – 2023 update. Neonatology. 2023;120(4):416–437.
[12] Polin RA, Papile LA, Baley JE. Respiratory distress syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
[13] Foglia EE, Kirpalani H. Continuous positive airway pressure for neonatal respiratory distress: current evidence and future directions. Clin Perinatol. 2023;50(2):265–281.
[14] Kaur C, Saini SS, Kaur R. Meconium aspiration syndrome: changing perspectives and outcomes. Indian J Pediatr. 2023;90(11):1034–1040.
[15] Jain S, Kumar P. Transient tachypnea of the newborn: an update. Pediatr Pulmonol. 2024;59(1):12–19.
[16] Li Y, Zhou J, Wang K, Chen X. Outcomes of minimally invasive surfactant therapy combined with non-invasive ventilation in preterm infants. Biomedicines. 2024;12(4):838
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
