ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MỘT SỐ NGUYÊN NHÂN SUY HÔ HẤP Ở TRẺ SƠ SINH TẠI BỆNH VIỆN ĐA KHOA NINH THUẬN

Abstract

Objectives: (1) To describe the clinical and paraclinical characteristics and selected causes of neonatal respiratory failure; and (2) to investigate the associations between selected clinical and paraclinical factors, causes, and the severity of respiratory failure. Materials and methods: A cross-sectional descriptive study was conducted on 109 neonates aged ≤7 days who were diagnosed with respiratory failure according to the 2003 WHO criteria and treated at the Department of Pediatrics, Ninh Thuan General Hospital, from May 2019 to May 2020. Results: Central cyanosis was present in 78.0% of cases, chest wall retractions in 53.2%, and tachypnea in 67.9%. In terms of severity of respiratory distress (RD), 23.9% were severe, 56.9% moderate, and 19.3% mild. The leading causes were hyaline membrane disease (33.0%), neonatal pneumonia (32.1%), transient tachypnea of the newborn (15.6%), and meconium aspiration pneumonia (7.3%). Univariate analysis identified five factors significantly associated with severe RD: birth asphyxia (OR = 43.33), rural residence (OR = 12.05), gestational age < 32 weeks (OR = 5.07), birth weight < 1500 g (OR = 4.80), and fetal distress (OR = 3.88). Multivariable logistic regression identified three independent factors: birth asphyxia (aOR = 60.85; 95% CI: 9.27-399.52; p < 0.001), rural residence (aOR = 19.61; 95% CI: 1.59-241.23; p = 0.020), and birth weight < 1500 g (aOR = 10.25; 95% CI: 1.75-60.07; p = 0.010). Conclusion: Hyaline membrane disease and neonatal pneumonia were the two leading causes of respiratory distress among early neonates at our locality. Birth asphyxia, preterm birth < 32 weeks, very low birth weight, and fetal distress were the main factors associated with severe respiratory distress and warrant early prevention and management.