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. 2024 Oct 24;24(1):677.
doi: 10.1186/s12887-024-05138-7.

Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants

Jeongmin Shin  1 , Chang Won Choi  2   3 , Byung Kook Lee  4
Affiliations

Risk factors for refractory respiratory distress syndrome among very-low-birth-weight infants

Jeongmin Shin et al. BMC Pediatr. .

Abstract

Background: The objective was to evaluate refractory respiratory distress syndrome (RDS) risk factors among very-low-birth-weight infants (VLBWIs).

Method: The data of VLBWIs born between January 2013 and December 2020 registered in the Korean Neonatal Network (KNN) were analyzed. Infants who died within 5 postnatal days or who were not given surfactant were excluded. Infants were divided into a well-responding RDS group, which received surfactant replacement therapy (SRT) only once, and a refractory RDS group, which received SRT twice or more. The associations between perinatal characteristics and refractory RDS were investigated via multivariate logistic regression analysis.

Results: Multivariate logistic regression analysis revealed that low gestational age (adjusted odds ratio [aOR] = 1.26, 95% confidence interval (CI) [1.23, 1.26], male sex (aOR = 1.17, 95% CI [1.06, 1.29]), cesarean section (aOR = 1.59, 95% CI [1.38, 1.80]), maternal hypertensive disorder (aOR = 1.54, 95% CI[1.35, 1.75]), and low 5-minute Apgar scores (aOR = 1.24, 95% CI [1.12, 1.37]) were significantly associated with refractory RDS. Antenatal corticosteroid use (aOR = 0.81, 95% CI [0.73, 0.89]) and maternal chorioamnionitis (aOR = 0.79, 95% CI [0.71, 0.88]) were significantly inversely associated with refractory RDS. Compared with well-responding RDS, refractory RDS was significantly associated with increased major neonatal morbidity and mortality risk at 5 postnatal days.

Conclusion: Maternal hypertensive disorder is a significant risk factor for refractory RDS. Refractory RDS was associated with unfavorable neonatal outcomes.

Keywords: Preeclampsia; Pregnancy-induced hypertension; Respiratory distress syndrome; Surfactant; Very-low-birth-weight infant.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study population Abbreviation: GA, gestational age; RDS, respiratory distress syndrome.
See this image and copyright information in PMC

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