Boletín médico del Hospital Infantil de México
versión impresa ISSN 1665-1146
LOPEZ-CANDIANI, Carlos; SANTAMARIA-ARZA, Claudia; MACIAS-AVILES, Héctor Alberto y CRUZ-GALICIA, Jannett. Respiratory distress due to surfactant deficiency in a third-level hospital with no in-patient deliveries. Factors related to mortality. Bol. Med. Hosp. Infant. Mex. [online]. 2010, vol.67, n.2, pp. 98-107. ISSN 1665-1146.
Background: Surfactant deficiency is a frequent cause of respiratory distress in the preterm newborn. The aim of this study is to determine the factors associated with mortality. Methods: We studied 257 cases in a tertiary-care neonatal intensive care unit with no in-hospital deliveries. We compared survivors and deaths with the χ2 test and calculated odds ratio and confidence interval at 95%. We subdivided the cases at 1500 g looking for any differences. Results: Of the newborns, 60% were male. Mean birth weight was 1666 g and gestational age was 31 weeks. In only 9% was there pulmonary maturation induction with steroids. Overall mortality was 30%. Statistical differences were found between live newborns and deaths according to mean birth weight (1812 g vs 1321 g, p <0.001) and gestational age (32 vs 29 weeks, p <0.001). Associated risk factors were maternal diabetes (OR 9.8, 95% CI: 1-89) and abortion threat (OR 13.2; 95% CI: 2.8-62). There was no difference between those babies who received or did not receive surfactant or when it was received before or after 3, 6 or 12 h. Conclusions: Mortality due to surfactant deficiency was high, especially among lower birth weight infants. Surfactant did not lower mortality in this group.
Palabras llave : newborn; preterm; respiratory distress syndrome; hyaline membrane disease; surfactant.