Respiratory distress in neonates with gestational age ≥ 35 weeks and associations between risk factors & respiratory distress

Abstract

Background: This study aimed to determine the incidence of respiratory distress among neonates ≥ 35 weeks gestational age requiring respiratory support and identify associated risk factors. Methods: A retrospective study at Al Wakra Hospital, Qatar, from January to December 2022, included neonates born at 35 weeks or later admitted to the NICU with respiratory distress requiring support. Results: During the study period, a total of 1194 out of 5637 (21.2%) neonates were admitted to the NICU for various reasons, of which 1062 (18.8%) were born at ≥ 35 weeks of gestational age. Among them, 485/5637 (8.6%) neonates were admitted to the NICU for respiratory distress and received respiratory support, with 442/5637 (7.84%) neonates included in the final analysis after applying the inclusion and exclusion criteria. The incidence of respiratory distress was highest in 35 weeks, with a progressive decline up to 39 weeks, followed by an increase. On adjusted analysis, significant predictors for respiratory distress included gestational age, cesarean delivery, instrument use, sex, fetal distress, meconium-stained liquor, 5-minute Apgar score, and resuscitation. Conclusions: Respiratory distress is a common cause of NICU admission among neonates with a gestational age of ≥ 35 weeks (8.6%). The incidence of respiratory distress was highest at 35 weeks, with a progressive decline up to 39 weeks, followed by an increase. Therefore, if possible, delaying delivery up to 39 weeks could be a good strategy to reduce respiratory distress in neonates with a gestational age of ≥ 35 weeks.