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Contribution of Elective Delivery to Severe Respiratory Distress at Term
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2002
Year
NeonatologyRespiratory Distress Syndrome (Pulmonary Critical Care)Pediatric Lung DiseaseSevere Respiratory DistressLung MaturitySepsisRespiratory Distress SyndromeAcute MedicineVentilationGestational AgeRespiratory Distress Syndrome (Neonatal Medicine)Pulmonary MedicineNewborn MedicineRespiration (Physiology)Neonatal ResuscitationPatient SafetyPediatricsMedicinePediatric Intensive CareAnesthesiologyNeonatal Pulmonary Physiology
We sought to determine the contribution of elective delivery to severe respiratory distress syndrome (RDS) on a weekly basis from 37-40 weeks' gestation. Chart reviews confirmed gestational age, delivery reason, and primary diagnosis of all inborn neonates with RDS requiring mechanical ventilation delivered at 37 0/7-40 6/7 weeks' gestation from 1/1/90-12/31/99. Exclusion criteria were sepsis, pneumonia, meconium aspiration, asphyxia, pulmonary hemorrhage, hydrops, chromosomal abnormality, or congenital malformations affecting respiration. Thirty-five thousand and thirty-one deliveries occurred from 37 0/7-40 6/7 weeks; 18 (0.05%) had RDS requiring mechanical ventilation. Nine infants delivered at 37 0/7-37 6/7 weeks, (OR for RDS = 38.5; 95% CI = 8.3, 178.3), seven delivered at 38 0/7-38 6/7 weeks, (OR for RDS = 13.3; 95% CI = 2.8, 64.0), and two delivered at 39 0/7-40 6/7 weeks. Six of 18 infants were electively delivered without documented lung maturity. Infants born at 37 0/7-38 6/7 weeks are at significantly increased risk for severe RDS. One third of RDS cases were potentially avoidable.