Usha Sidramappa Agashe, Ashwin Borade, Shirish Gulawani, Ram Dhongade
Department of Pediatrics, Sant Dnyaneshwar Medical Education and Research Centre, Pune, Maharashtra , India
Background: Respiratory distress syndrome (RDS) is one of the most frequent causes for respiratory distress in the preterm newborn. It is one of leading cause of mortality in developing country.
Objective: This study investigated the influence of maternal risk factors and effect of antenatal steroid in pulmonary maturity in preterm newborn.
Material and method: This was a prospective cohort study of 142 preterm babies who were selected randomly and were assessed for development of RDS. Maternal risk factors like pregnancy induced hypertension (PIH), premature rupture of membranes (PROM), anemia, maternal diabetes, twin gestation, high and low socio-economic classes were studied in relation to development of RDS in the preterm newborns. Each group of babies with maternal risk factors was compared with uncomplicated group with respect to the development of RDS. Newborn with antenatal steroid treatment were compared with newborn without antenatal steroid with respect to development of RDS.
Results: Prolonged rupture of membranes, higher socio-economic class, male gender, intrauterine growth restriction were risk factors for RDS, whereas pregnancy induced hypertension, maternal anemia, lower socio-economic class, female gender, appropriate for gestational age (AGA) babies, and antenatal steroid causes accelerated pulmonary surfactant maturity in preterm newborn. RDS incidence decreased with increase in gestational age, and increase in birth weight, but it was not statistically significant. Twin gestation and maternal diabetes does not appear to be a risk factor in development of RDS. Antenatal steroid is unable to demonstrate the beneficial effect in babies with PIH, PROM, male gender and small for gestational age (SGA) babies compared to non- steroid group.
Conclusion: There are several risk factors which influence pulmonary maturity in preterm babies and if identified early with appropriate interventions can prevent RDS.