Abstract:
Background: Prematurity is one of the primary causes of infant death in Afghanistan, and it complicates a variety of critical issues, such as respiratory distress syndrome (RDS). Although RDS has been associated with serious consequences, there is a lack of scientific information on the associated factors of this problem in Afghanistan; hence, this study was undertaken to fill that gap. The purpose of this study was to find the occurrence rate and associated factors of RDS in premature neonates.
Methods: This retrospective cross-sectional study was conducted at the Neonatal Intensive Care Unit of the French Medical Institute for Mothers and Children Hospital in Kabul City, Afghanistan during 2020-2021. Statistical analysis was performed by SPSS 26 and specific statistical methods.
Results: A total of 78 preterm newborns were enrolled in this study, and respiratory distress syndrome developed in 51.3 % of them. Based on gestational age, the occurrence rates of RDS within groups of extremely, early, moderate and late preterm neonates were 100%, 55.6%, 44%, and 35.7 respectively. The occurrence of RDS was found to be 100% in extremely low birth weight, 56.2% in very low birth weight, and 58.8% in low birth weight neonates. The gestational ages of these infants had a positive correlation with birth weights (r=.648, p= 0.01, n=78). The preterm neonates in the RDS group versus the non-RDS group had a mean birth weight of (1610±314.4g vs 1981±520.3g,P=0.005), a mean gestational age of (31.65±2.2w vs 33.18± 2.10w,P=0.003), and a mean hemoglobin level of (13.85± 3.28g vs16.09± 3.26g, P=0.003). There was a significant association between RDS and neonatal anemia (AOR=5.9, P=0.008), neonatal sepsis (AOR=4.2, P=0.01), vaginal delivery (AOR=8.7, P=0.01), delivery at low-resourced settings (AOR=2.7, P=0.01), PROM (AOR=4, P=0.02), and antepartum hemorrhage (6.9, P=0.01). The mortality rate in preterm neonates was found to be 26.8% that was significantly associated with very and extremely low birth weights (AOR=8.2, P=0.03), early and extremely preterm births (AOR=6.3, P=0.03), female gender (AOR=3.8, P=0.04), antepartum hemorrhage (AOR=4.6, P=0.01) and PROM (AOR=5.7, P=0.01).
