Acute neonatal respiratory distress in Italy: a one-year prospective study

A prospective multicentre 12-month survey of neonatal respiratory disorders in 63 537 Italian infants was performed to evaluate the incidence of acute neonatal respiratory disorders and of the main related complications. A to tal of 1427 developed respiratory disorders (2.2%), 208 of whom died (14.6% ). The incidence of respiratory distress syndrome was 1.16%, with a case fa tality rate (CFR) of 24%; that of transient tachypnoea was 0.93%, with a CF R of 1.3%. The rates of meconium aspiration syndrome, persistent pulmonary hypertension and pneumonia were 0.06%, 0.02% and 0.07%, with CFRs of 10.3%, 38.5% and 21.7%, respectively. The occurrences of the main complications i n affected newborns were: bronchopulmonary dysplasia 5.6%, necrotizing ente rocolitis 1.7%, patent ductus arteriosus 9.8%, 3 degrees and 4 degrees grad e intraventricular haemorrhage 6.8% and air leak 4.9%. It was concluded tha t the incidence of acute neonatal respiratory disorders and the main relate d complications was lower than that reported two decades ago and that the C FR of acute neonatal respiratory disorders had increased. These results may be the consequences of (i) progress in the management of high-risk pregnan cies, (ii) an increased number of viable infants with extremely low birth w eight and (iii) diffusion of antenatal treatment with corticosteroids which , in this series, seemed to reduce the morbidity but not the mortality in t he high-risk infants.