Maternal and neonatal risk factors for neonatal respiratory distress syndrome in term neonates in Cyprus: a prospective case–control study

• Published in: Italian journal of pediatrics 2021-06, Vol.47 (1), p.1-129, Article 129
• Main Authors: Stylianou-Riga, Paraskevi, Boutsikou, Theodora, Kouis, Panayiotis, Kinni, Paraskevi, Krokou, Marina, Ioannou, Andriani, Siahanidou, Tania, Iliodromiti, Zoi, Papadouri, Thalia, Yiallouros, Panayiotis K., Iacovidou, Nicoletta
• Format: Article
• Language: English
• Subjects: Age; Apgar score; Blood transfusion; Caesarean section; Data collection; Gender; Gestational age; Gestational diabetes; Hypertension; Hypotension; Infections; Intensive care; Maternal risk factors; Multivariate analysis; Neonatal respiratory distress syndrome; Neonatal risk factors; Neonates; Nutrition; Parenteral nutrition; Preeclampsia; Pregnancy complications; Premature birth; Pulmonary hypertension; Regression analysis; Respiration; Respiratory distress syndrome; Risk factors; Surfactants; Therapeutic applications; Ventilators
• ISSN: 1824-7288; 1720-8424; 1824-7288
• DOI: 10.1186/s13052-021-01086-5

Background Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Methods In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017–October 2018. Clinical data were obtained from patients’ files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively. Results During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03–18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80–78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: − 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p