Respiratory distress in newborns: current state of the problem

Abstract

Introduction. Respiratory distress of newborns is one of the most common causes of complications, irreversible damage to the central nervous system and deaths in the neonatal period.The objective was to analyze the current features of epidemiology, risk factors and outcomes of respiratory distress (RD) in newborns according to the literature.Materials and methods. The analysis includes 112 publications included in the abstract PubMed database for the period from 2017 to 2023. The search was carried out using keywords: respiratory distress, respiratory distress syndrome, newborns, favorable outcome, unfavorable outcome, risk factor, epidemiology. After the initial study of abstracts, 62 articles were excluded from the review on predicting disease outcomes and the effect of therapeutic measures on the course of respiratory failure in the neonatal period.Results. Studies on the epidemiology of respiratory distress in newborns are very numerous, but the information available in them is extremely heterogeneous and cannot be extrapolated to patients with neonatal ICUs all over the world. Low weight and short gestation at the time of birth are the main risk factors for an unfavorable neonatal period outcome, especially in developing countries. A special risk group is prematurity with extremely low body weight, especially if they have severe infections and sepsis. Severe hypoxemic respiratory failure in the neonatal period in full-term newborns, in most cases, is noted in persistent pulmonary hypertension, which requires significant costs of all health care resources. Therapeutic strategies that have significantly reduced mortality in newborns with RD are surfactant replacement therapy and various options for non-invasive respiratory support.Conclusion. The most frequent cause of hypoxemic respiratory failure in the neonatal period is respiratory distress syndrome and transient tachypnea of newborns, which is due to nursing full-term newborns and increasing indications for surgical delivery.