Heterogeneity of respiratory distress syndrome: risk factors and morbidity associated with early and late gestation disease

BMC Pregnancy and Childbirth

Research Article

Sarka Lisonkova¹  Azar Mehrabadi²  K.S. Joseph³ 

[1] Department of Obstetrics and Gynaecology, University of British Columbia and the Children’s and Women’s Hospital and Health Centre of British Columbia, Vancouver, BC, Canada;Department of Obstetrics and Gynaecology, University of British Columbia and the Children’s and Women’s Hospital and Health Centre of British Columbia, Vancouver, BC, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave. West, H3A 1A2, Montreal, QC, Canada;Department of Obstetrics and Gynaecology, University of British Columbia and the Children’s and Women’s Hospital and Health Centre of British Columbia, Vancouver, BC, Canada;School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada;

关键词: Respiratory distress syndrome;    Respiratory morbidity;    Hyaline membrane disease;    Preterm;    Term newborns;    Gestational age;    Risk factors;   

DOI  :  10.1186/s12884-016-1085-7

 received in 2015-10-09, accepted in 2016-09-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAlthough respiratory distress syndrome (RDS) is considered a disease of prematurity, there is evidence to suggest heterogeneity between early and late gestation RDS. We examined the epidemiologic features of RDS occurring at early and late gestation.MethodsWe conducted a retrospective cohort study including live births in the United States in 2005–06, with information obtained from the National Center for Health Statistics. Early (<32 weeks) and late gestation RDS (≥39 weeks) were contrasted in terms of risk factors and associations with pregnancy complications, obstetric intervention and co-morbidity. Logistic regression was used to quantify the effects of risk factors, while other associations were quantified descriptively.ResultsThere were 27,971 RDS cases, yielding an incidence of 6.4 per 1000 live births. Early and late gestation RDS differed in terms of risk factors, with factors such as multi-fetal gestation more strongly associated with early (adjusted odds ratio [aOR] 11.6, 95 % confidence interval 11.0–12.2) compared with late gestation RDS (aOR 3.66, 95 % confidence interval 2.68–4.98). The morbidity correlates of early and late gestation RDS also differed substantially; neonatal seizures were less strongly associated with early (OR 5.90, 95 % confidence interval 3.67–9.47) compared with late gestation RDS (OR 33.1, 95 % confidence interval 27.2–40.2), while meconium aspiration syndrome was not significantly associated with early gestation RDS (OR 1.87, 95 % confidence interval 0.94–3.72) and very strongly associated with late gestation RDS (OR 39.8, 95 % confidence interval 34.7–45.6).ConclusionsDifferences in risk factors and morbidity correlates of early and late gestation RDS suggest that these entities represent two distinct diseases.

【 授权许可】

CC BY   
© The Author(s). 2016