SHORT AND MIDTERM OUTCOME OF 1157 NEONATE S WITH RESPIRATORY-DISTRESS-SYNDROME

Background. - Data concerning neonates with acute respiratory distress syndrome (RDS) are still scarce. The characteristics and follow-up of a French cohort which has participated in an international trial conc erning the efficacy of artificial surfactant have been studied. Popula tion and methods. - One thousand one hundred and fifty-seven neonates admitted from October 1990 to December 1991 in 27 French intensive car e units because of RDS due to hyaline membrane disease were included i n the study, whatever their birthweight and gestational age (GA). Resu lts. - Three hundred and sixteen neonates (27.3%) were born from twin or multiple pregnancies. Fourty-five (5.5%) of the mothers had been gi ven corticosteroids for the week preceding delivery. 55.5% were delive red by cesarean section. Mean GA was 31.0 +/- 2.9 weeks and mean birth -weight was 1603 +/- 625 g. Two hundred and sixty-six neonates (23%) w ere small for GA. Two hundred and twenty-three died after a mean survi val of 4.2 days (63% before the end of the first week and 80% before t he end of the third week). Fifty percent of these deaths were due to r espiratory distress, 28% to severe brain disorders and 9% to infection s. The bronchopulmonary dysplasia rare was 21.7%. Early ultrasound sca n of the brain showed major injuries in 19.5% of cases; the second sca n performed in 822 infants was normal in 84.3%. Conclusions. - Taking into account GA, mortality and morbidity rates were similar to those o f the other non-French participating centres.