Abstract
This study was undertaken to assess the Idiopathic Respiratory Distress Syndrome (IRDS) in premature infants whose birth weights exceeded 1820 gms (4 lbs). During the past 3 years 66 (41%) of 160 infants admitted to our Newborn ICU with IRDS weighed more than 1820 gms. Thirty of the 66 were transferred from outlying hospitals. Estimated gestational ages ranged from 34-38 wks with a mean of 35.7. Birth weights ranged from 1820-3856 gms with a mean of 2358 gms. There was a predominance of males.
Of the various prenatal conditions assessed, 80% of the 66 mothers were > 20 yrs of age and 67% were multigravid. Twenty percent of the mothers had complications of pregnancy including 4 diabetics, 2 narcotic addicts, and 1 toxemic. Thirty-three percent were delivered by c-section.
The severity of IRDS in this group of infants was variable. Half of the infants required oxygen in concentrations > 60%. Assisted ventilation was needed in 87% of those transferred and 47% of those delivered at our hospital. Apgar scores and initial blood gases were not useful in predicting the subsequent need for ventilation assistance. Seven of the 66 infants expired. Pneumothorax and cerebral hemorrhage were encountered in 4 of the 7.
It is concluded that IRDS may be severe in a surprising number of large birthweight prematures. It is unclear whether IRDS occurs more frequently at higher altitudes (5000 ft) and is more severe. It is recommended that these infants be evaluated and followed as closely as their smaller-weight counterparts.
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Coen, R., Papile, LA. & Mortimer, E. EXPERIENCE WITH IRDS IN LARGE BIRTHWEIGHT PREMATURES. Pediatr Res 8, 444 (1974). https://doi.org/10.1203/00006450-197404000-00626
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DOI: https://doi.org/10.1203/00006450-197404000-00626