Clinical features of full term infants and preterm infants with respiratory distress syndrome

Abstract:

Objective：To investigate the different clinical characteristics of respiratory distress syndrome（RDS）with various gestational ages and to guide the clinician to prevent and treat RDS correctly. Methods：A total of 1 133 cases of RDS whose admission ages were less than 2 d in our department from January 2008 to December 2012 were divided into full-term group and preterm group according to gestational age. According to illness severity，all patients were subdivided into mild group and severe group. The clinical data in each group were analyzed. Results：Mild preterm group had 542 cases（67.3%）；353（65.1%） were performed with cesarean delivery and 354（65.3%） were treated with pulmonary surfactant（PS）. Chest X-ray was improved in 230 infants（65.0%） after using PS with－in 48 h. The time for assisted ventilation was 76.0 h and 41 cases（7.6%） complicated with pulmonary air leak. Mild full-term group had 200 cases（61.0%），187（93.5%） were performed with cesarean delivery（compared with that in mild preterm group， χ2=59.352，P=0.000） and 74（37.0%） were treated with PS（χ2=47.979，P=0.000）. Chest X-ray was improved in 35 infants（47.3%） after using PS within 48 h（χ2=8.108，P=0.004）.The time for assisted ventilation was 90.0 h（Z=-2.261，P=0.024） and 28 cases（14.0%） complicated with pulmonary air leak（χ2=7.713，P=0.007）. Severe preterm group had 263 cases（32.7%）；173（65.8%） performed with cesarean de－livery and 193（73.4%） were treated with PS；13 cases（4.9%） complicated with pulmonary air leak. Severe full-term group had 128 cases（39.0%）（compared with that in severe preterm group，χ2=4.163，P=0.041）；122（95.3%） performed with cesarean delivery（χ2=40.538，P=0.000） and 77（60.0%） treated with PS（χ2=7.050，P=0.008）；19 cases（14.8%） complicated with pulmonary air leak（χ2=11.231，P=0.001）. Conclusion：（1）Different clinical characteristics between preterm RDS and full-term RDS lie in risk factors，illness severity，treatment response，complications and prognosis，etc. Gestational age should be taken into consideration when diagnosing and treating RDS. （2）Full-term RDS are characterized by clinically severity and frequently pulmonary air leak compared with that of preterm RDS，therefore more attention should be paid to its early diagnosis and treatment.