رابطه نوع زايمان و خطر بيماري تنفسي نوزادان

CORRELATION BETWEEN THE MODE OF DELIVERY WITH THE RISK OF NEONATAL RESPIRATORY MORBIDITY

BACKGROUND AND OBJECTIVE: Respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN) are the most frequent acute respiratory morbidity in newborns which vary according to the mode of delivery. The purpose of this study was to determine the influence of delivery mode on the frequency of RDS and TTN in newborns based on gestational age and fetus gender. METHODS: This prospective study was performed on all newborns delivered in Babol Clinic hospital, Babol, Iran during 2006. All newborns delivered by three different delivery modes: vaginally delivery (VD) (n=380), cesarean delivery without labor (elective cesarean, n=1305) and cesarean in labor (emergency cesarean, n=338) were assessed according to RDS and TTN observed in newborns. Neonates with anomaly, asphyxia and meconium staining amniotic fluid were excluded from this study. Data was analyzed using Fisher exact test and relative risk (RR) was calculated. FINDINGS: Frequency of RDS in cesarean section was more than vaginal delivery (8.5% vs 4.9%), (RR=1.7, 95% CI= 1.05-3), p=0.016. Frequency of RDS in elective cesarean was more than emergency cesarean (9.3% vs 5.7%), (RR=1.7, 95% CI= 1.04-2.7), p=0.017. Frequency of RDS in elective cesarean in neonates more than 37 weeks gestational age was more than emergency cesarean (8.6% vs 1.1%), (RR=1.8, 95% CI= 1.2-2.6), p=0.000. Frequency of TTN in cesarean section was more than vaginal delivery (9.2% vs 3.1%). (RR=3.1, 95% CI= 1.6-6.1), p=0.000. Frequency of RDS in boys was more than girls (10% vs 5.8). CONCLUSION: The results showed that the occurrence rate of RDS and TNN in newborns delivered by elective cesarean and male fetus was more. So neonatal care plan for decreasing cesarean without labor is necessary especially in male fetus.