High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

Background: Respiratory distress syndrome (RDS) is a common critical disease in term neonates, but reasons for the occurrence of RDS remains unclear. Aims: This study aimed to investigate the cause of RDS in full-term neonates by a retrospective case-control study. Study Design: Case-control study. Methods: Among the patients admitted to Bayi Children's Hospital between January 2008 and December 2010, a total of 205 full-term neonates with RDS were assigned to the study group, and 410 full-term neonates without RDS were assigned to the control group. Clinical information, including the presence or absence of premature rupture of membranes (PROM), gender of the neonates, mode of delivery, birth weight, and any conditions suffered by the neonates were recorded. Results: The results of logistic regression analysis showed that the following causes were closely correlated with term neonatal RDS: selective cesarean section (OR: 8.737; 95% CI: 5.232-14.588), severe birth asphyxia (OR: 6.988; 95% CI: 2.990-16.333), small gestational age (OR: 6.222; 95% CI: 2.001-8.993), maternal-fetal infection (OR: 5.337; 95% CI: 1.999-8.233), PROM (OR: 3.380; 95% CI: 1.986-5.754), male sex (OR: 2.641; 95% CI: 1.721-4.053), gestational glucose intolerance or diabetes (OR: 2.415; 95% CI: 1.721-4.053), and low birth weight (OR: 2.323; 95% CI: 1.329-4.060). Conclusion: Several high-risk factors, such as selective cesarean section, severe birth asphyxia, maternal-fetal infection, PROM, and male sex are closely correlated with full-term neonatal RDS. These could provide a significant reference for the diagnosis and treatment of term neonatal RDS.