The epidemiology of respiratory failure in neonates born at an estimated gestational age of 34 weeks or more

Abstract

Objective: To prospectively evaluate the primary causes for the use of mechanical ventilation in near-term neonates and to determine the rates of death, chronic lung disease, and neurological complications in these infants.

Study design: We collected data on 1011 neonates who were > or =34 weeks' estimated gestational age; intubated within 72 hours of birth; and expected to require ventilation for more than 6 hours.

Results: The study population had a mean estimated gestational age of 37+/-2 weeks; had a mean birth weight of 2.9+/-0.6 kg; and were predominantly male (62%), white (69%), and delivered by cesarean section (55%). Respiratory distress syndrome (n=437) was the most common pulmonary illness. Chronic lung disease was diagnosed in 109 (11%); neurological complications were reported in 86 (9%); and 51 (5%) patients died.

Conclusions: Neonates > or =34 weeks who require mechanical ventilation represent a high-risk population who have significant morbidity and mortality.