Predictors, etiologies and outcomes of neonatal respiratory distress in a reference neonatal unit in Cameroon: a historical cohort study.
Choukem S P ; Langmia N R ; Barla M E ; Koki N P
CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PL017
Neonatal respiratory distress (NRD) is a main cause of neonatal morbidity and mortality in low-income countries, where early detection of its risk factors and early treatment of its etiologies are major challenges. However, few studies in low-income countries have provided data needed to tackle it.
To determine the predictors, etiologies and outcomes of NRD in a tertiary health care center of Cameroon.
This historical cohort study compared socio-demographic and clinical variables between the hospital records of newborns with NRD to those without NRD admitted consecutively to the Neonatal unit of Douala General Hospital over a period of 26 months. Both groups were matched for gestational age, birth weight, maternal age, parity and followed-up till discharge for outcomes. NRD was diagnosed based on the presence of an abnormal respiratory rate and one or more of the following signs: expiratory grunting, nasal flaring, intercostal recessions, xiphoidal recessions, thoraco-abdominal asynchronic movements and cyanosis, in their records. Predictors of NRD were investigated using multivariate logistic regressions.
Between the study periods, NRD accounted for 47.5% of neonatal admissions. 334 newborns with NRD were compared to 369 without NRD. Acute fetal distress, elective caesarean delivery, APGAR score < 7 at the 1st minute, prematurity, male gender and birth weight ≥ 4000 grams were independent predictors of NRD (all p < 0.05). The main aetiologies were neonatal infections (31%) and transient tachypnoea of the newborn (25%). The neonatal mortality rates of newborns with NRD and those without NRD were 24.5% and 11.4%, respectively (p < 0.001). Major causes of NRD-related deaths were neonatal sepsis (43%), prematurity (24%) and hypoxic ischaemic encephalopathy (16%).
Neonatal respiratory distress is a frequent emergency associated with a significant mortality in our reference neonatal unit. Most of its risk factors and etiologies are preventable. Adequate follow-up of pregnancy and labor for timely intervention may improve the neonatal outcome.
Neonatal respiratory distress, predictors, etiologies, outcomes, Cameroon.