EPIDEMIOLOGY OF NEONATAL ACUTE RESPIRATORY DISORDERS - A MULTICENTER STUDY ON INCIDENCE AND FATALITY RATES OF NEONATAL ACUTE RESPIRATORY DISORDERS ACCORDING TO GESTATIONAL-AGE, MATERNAL AGE, PREGNANCY COMPLICATIONS AND TYPE OF DELIVERY

A prospective 3-month survey of neonatal respiratory disorders in 17,1 92 Italian infants born in 65 hospitals, located in 17 Italian regions representative of northern, central and southern Italy, was performed to evaluate the incidence of neonatal acute respiratory disorders and their risk factors. The prematurity rate was 7.3%, while the extremel y low birth weight (< 1,000 g) and very low birth weight (< 1,500 g) r ates were 0.58% and 0.99%, respectively. Four hundred and ninety-one i nfants (2.8%) developed respiratory signs. Lethality or specific fatal ity rate (SFR) for acute respiratory disorders with regard to the over all study population was 0.45%. The male/female ratio of affected infa nts was 1.3:1. Among affected newborns the case fatality rate (CFR) fo r respiratory disorders was 15.88% (78/491) and was higher in males th an in females (2:1), in infants with a gestational age of less than or equal to 28 weeks (60%) and birth weights of <1,000 g (50%). Moreover , the SFR was higher (p < 0.05) in the infants of mothers older than 3 4 years. SFR was 3.0% in intrauterine growth-retarded infants, 3.6% in the first twin and 3.2% in the second twin. An Apgar score of less th an or equal to 3 at 5 min was strongly related to the incidence of res piratory disorders (47.1%). The antenatal prevention of neonatal respi ratory distress syndrome with maternal corticosteroid treatment was pe rformed in 84% of newborns (<32 weeks) with respiratory problems in no rthern Italy, and about 25% and 38% in central and southern Italy, res pectively. The CFR was double in southern Italy as compared with north ern and central Italy. Prematurity, low birth weight and a low Apgar s core (less than or equal to 3) at 1 and 5 min as well as a maternal ag e of > 34 years are risk factors for acute respiratory disorders.