Incidence, Clinical Features, and Outcomes of Transient Tachypnea of the Newborn at a Tertiary Care Center in Western India

Abstract

Background Transient tachypnea of the newborn (TTN) is a self-limiting, benign condition leading to respiratory distress shortly after birth. It is among the leading cause of respiratory distress in term and late preterm neonates. The disease is transient and resolves by three to four days in most neonates. Objective The objective of this study was to study the incidence of TTN, its clinical features, predictors of outcomes and duration of hospital stay in these neonates suffering from it. Methods This was a prospective study done at a tertiary care center carried out between August 2019 to July 2021. The study subjects were late pre-term (34 to 36 weeks of gestation) and term neonates with respiratory distress who were admitted to the neonatal intensive care unit (NICU). The diagnosis was based on clinical features, radiological features, and clinical course in NICU. Results The total number of cases with TTN was 74. The incidence of TTN was 16 per 1000 live births. 63.5% were male, 75.7% were term births, 70.3% were born via lower section cesarean section (LSCS), and 66.2% were normal birth weight (≥2.5 kg) infants. A high incidence of TTN was found in late pre-term babies, babies born via LSCS, and male sex. None of the neonates required ventilatory support, either noninvasive or invasive. Conclusion Delivery by LSCS and male sex were risk factors for the development of TTN. The distress in TTN is usually mild to moderate, and in most cases, oxygen supplementation suffices. Higher Downes' score at presentation, low birth weight, preterm, and delivery by LSCS were found to be predictors for a longer duration of distress and thus the longer duration of NICU stay. Although severe complications for TTN have been reported in the literature, they are rare. Careful observation can decrease not only a lot of unnecessary investigations but also allow clinicians at secondary and primary centers to better care for neonates with TTN.

Keywords: newborn distress; respiratory distress in newborn; transient tachypnea of newborn; ttn; ttnb.

Figure 1. Chest radiograph in transient tachypnea of the newborn

The radiograph shows typical features of TTN. Straightened ribs and increased intercostal space due to mild hyperinflation lungs. streaky infiltrates (white asterisks), fluid in horizontal lung fissures (white arrow), perihilar streaking (Sunburst)