Effects of perinatal risk factors on common neonatal respiratory morbidities beyond 36 weeks of gestation

OBJECTIVES: To assess the incidence of respiratory morbidity (RM) in all single live neonates born >36 weeks of gestation, and the effects of perinatal characteristics on these morbidities.

METHODS: This is a prospective hospital based study covering a 12-month period. The study took place at the Department of Pediatrics, Jordan University Hospital, Amman, Jordan, between January and December 2009. The effects of different perinatal characteristics on RM including transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) were analyzed.

RESULTS: A total of 2282 newborns were included. One thousand two hundred and seventy-six (55.9%) of the newborns were delivered by vaginal delivery and 1,006 (44%) by cesarean section (CS) (24.5% by emergency CS and 19.5% by elective CS). Respiratory morbidity was reported in 3.7%. The incidence of TTN was 2.9% and RDS was 0.7%. Elective CS was found to be a risk factor for RM development when the gestational age was <39 weeks. Maternal hypertension and diabetes mellitus, and the absence of labor were independent risk factors for RM. The emergency CS and large for gestational age babies were risk factors for TTN, while male gender and GA <37⁰⁺⁶ weeks were risk factor for RDS.

CONCLUSION: The collaborative obstetric and neonatology responsibility helps to identify the risk factors for adverse respiratory outcome when considering the time and mode of delivery. The pregnant mother should be informed regarding this possibility if delivery by elective CS is performed before the 39⁰⁺⁶ weeks of gestation.