Treatment Outcomeand Risk Factors Associated mortality of Persistent Pulmonary Hypertension of Newborn in Sunpasitthiprasong Hospital

Abstract

Introduction : Late preterm newborns are infants with the same physiological imperfections as normal preterm infants. It was found that infants had various medical conditions; especially the respiratory problem. Antenatal glucocorticoids in pregnant women with preterm labor are widely used in the guidelines of the Royal College of Obstetricians and Gynecologists. This is because studies have shown that antenatal glucocorticoids reduce the incidence of respiratory distress syndrome. However, there are no clear guidelines for antenatal glucocorticoids administration in late preterm mothers.

Objective: To determine the association between antenatal corticosteroid and respiratory distress syndrome and other respiratory complications in late preterm infants who admitted at Sunpasitthiprasong hospital.

Methods: A retrospective observational analytical study by collecting data from medical records of 194 late preterm infants who were admitted to Sunpasitthiprasong hospital from 1 January 2017 to 31 January 2019. Patients were randomized method into two groups; dexamethasone group and non-dexamethasone group.

Results: 194 late preterm infants who were admitted to Sunpasitthiprasong hospital. They were devived into two groups; 97 patients in dexamethasone group and 97 patients in nondexamethasone group. The study showed late preterm infants with respiratory distress syndrome were 27 cases (13.9 %). Respiratory distress syndrome occurred significantly less frequently in dexamethasone group (8.2%) compared with non dexamethasone group (19.6%) (p 0.023). Others respiratory complications: transient tachypnea of the newborn was the most common complication 79 cases (40.7%), followed by delay adaptation 27 cases (13.9 %) and congenital pneumonia 14 cases (7.2 %). Eighteen late preterm infants with respiratory distress syndrome (66.7%) required endotracheal intubated and mechanical ventilation. The factors are associated with respiratory distress syndrome were antenatal corticosteroid (dexamethasone), birth weight and APGAR score at 5 ≤ 7.

Conclusion: Administration of dexamethasone to mothers of late preterm infants was associated with a reduction in the incidence of respiratory distress syndrome and other respiratory complications. Transient tachypnea of the newborn was the most common respiratory complication in late preterm infants.