The rate of prematurity has increased markedly over the last 20 years. These preterm infants have a high risk of morbidity, especial respiratory, compared to full-term infants. Nasal continuous positive airway pressure (NCPAP) has significantly improved the prognosis of this respiratory distress (MMH).
The objective: The objective of this work was to study risk factors and management of respiratory pathology in premature newborns at the EHS NOUAR FADELA.
Patients and methods: This is a retrospective, descriptive, mono-centric study including all newborns having recourse to CPAP and managed in a level IIb maternity hospital at the E Nouar Fadela between January 2019 and June 2021. Pearson's Chi-squares were used for statistical testing. A p-value<0.05 represented a statistically significant difference.
Results: We recorded 12633 deliveries of which 623 were preterm births representing 4.93% of births. For maternal characteristics: the average age was 29 ±5.57 years. Maternal morbidity was present in 20.9% gravidic hypertension and 11.7% gestational diabetes. Neonatal morbidity was dominated in preterm newborns was respiratory distress in 41.4%. Mechanical ventilation was necessary in 12.6% of cases. The two main causes of respiratory distress were MMH, maternal-fetal infection, respiratory distress, and respiratory failure. Significant risk factors for respiratory distress were gestational age, male sex and pre-labour caesarean birth (p<0.05).
Conclusion: The use of NIV in newborns with respiratory distress is not negligible. Our results confirm the effectiveness of NIV. It is also essential to limit the use of pre-labour caesarean section to these terms whenever possible.
La prématurité : Profil épidémiologique et devenir à court terme. Expérience du CHU Mohamed VI. 2009. French.
Engle WA, Tomashek KM, Wallman C. Late-preterm’ infants: a population at risk. Pediatrics. 2007; 120: 1390–401.
Young PC, Glasgow TS, Li X, Guest-Warnick G, Stoddard G. Mortality of late-preterm (near-term) newborns in Utah. Pediatrics. 2007; 119: e659–65.
Tomashek KM, Shapiro-Mendoza CK, Davidoff MJ, Petrini PR. Differences in mortality between late-preterm and term singleton infants in the United States, 1995–2002. J Pediatr. 2007; 151: 450–6.
Berthelot-Ricou A, Lacroze V, Courbie`re B, Guidicelli B, Gamerre M, Simeoni U. Morbidite´ respiratoire des nouveau-ne´s, de 34 a` 37 SA, issus de ce´sariennes avant travail. Arch Pediatr. 2011; 18: 39–40. French.
Champion V, Durrmeyer X, Dassieu G. Devenir respiratoire a` court terme d’une population d’enfants ne´s a` 34,35 et 36 SA dans une maternite´ de niveau III. Arch Pediatr. 2010; 17: 19–25. French.
Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003; 102: 488–92.
Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics. 2006; 118: 1207–14.
Foix-L’Helias L. E´pide´miologie et pe´diatrie de maternite´. Quelles e´tudes autour des enfants moins grands pre´mature´s "late preterm infants". In: 21e Se´minaire Guigoz. Groupe d’e´tude en ne´onatologie; 2006: 427–30. French.
Hansen AK, Wisborg K, Uldbjerg N, Brink Henriksen T. Elective caesarean section and respiratory morbidity in the term and near-term neonate. Acta Obstet Gynecol Scand. 2007; 86: 389–94.
Jain L. Respiratory morbidity in late preterm infants: prevention is better than cure! Am J Perinatol. 2008; 25: 75–8.
Joseph KS, Nette F, Scott H, Vincer MJ. Prenatal corticosteroid prophylaxis for women delivering at late preterm gestation. Pediatrics. 2009; 124: e835–43.
Hunt CE. Ontogeny of autonomic regulation in late preterm infants born at 34–37 weeks postmenstrual age. Semin Perinatol. 2006; 30: 73–6.
Henderson-Smart DJ. The effect of gestational age on the incidence and duration of recurrent apnoea in newborn babies. Aust Paediatr J. 1981; 17: 273–6.
Kinney HC. The near-term (late pre-term) human brain and risk for periventricular leukomalacia: a review. Semin Perinatol. 2006; 30: 81–8.
Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics. 2006; 118(3): 1207-14.
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