Pattern of Respiratory Problems in Neonates in a Level III Neonatal Care Unit with Special Reference to Pneumonia

Abstract

Introduction: Respiratory distress constitutes one of the commonest cause of morbidity and mortality in the neonatal period. It is more commonly encountered within the first 48-72 hours of life. Aim: To find out the incidence, causes and outcome of respiratory distress in inborn newborn babies and also to determine the common organisms of pneumonia. Settings and Design: A hospital based prospective study was carried out for a period of 7 months (October 2015 to April 2016) in the NICU (Neonatal Intensive Care Unit) of AMCH (Assam Medical College and Hospital) . Materials and Methods: All inborn newborn babies admitted to NICU of AMCH who developed respiratory symptoms were included in the study. Maternal and baby details were filled up in a predesigned structured proforma. Statistical Analysis: Data were entered in SPSS (Software package for statistical analysis), version 16 and the frequencies were analyzed. Results: Of all the inborn deliveries during our study period, 5.3% developed respiratory distress. It constituted 22.4% of all NICU admission, 61.5% were males and 38.5% were females. TTNB was the most common cause (42.8%) of respiratory distress followed by pneumonia (29.6%), sepsis (8.9%), MAS (8.2%) and RDS (5.9%). TTNB was more in term babies (54.6%), RDS among preterm babies (94.4%) and MAS was found exclusively in the term babies. Of the 90 Pneumonia cases, sepsis screen was positive in 87.8% cases and blood culture was positive in 14.4% cases. The most common organism was CONS (coagulase negative staphylococcus) which was found in four cases (4.4%), followed by acinetobacter in three cases (3.33%) and klebsiella in two cases (2.2%). In the pneumonia cases, predisposing factors like PROM was detected in 25.6%, maternal fever in 16.6% and foul smelling liquor in 11.1%. The overall case fatality rate is 23%. Mortality is highest (77.8%) in RDS. Conclusion: Respiratory distress is a common cause of NICU admission, TTNB being the commonest cause, followed by pneumonia. The burden of neonatal pneumonia is high in our NICU

Keywords

• blood culture
• newborn
• respiratory distress.