Respiratory Distress in the Neonatal Intensive Care Unit: Prevalence and Key Etiological Factors

Open Access

Abstract

Background: Respiratory distress in newborns, marked by tachypnoea, grunting, retractions, or cyanosis, is a common cause of urgent NICU admission, especially in South Asia. This study aimed to determine the prevalence of respiratory distress among NICU-admitted patients and to identify key etiological factors and associated other conditions. Methods & Materials: This hospital-based observational descriptive analytic study was conducted in the NICU of Uttara Crescent Hospital, Dhaka, Bangladesh, from February 2023 to January 2024, including 169 consecutive neonatal admissions over one year. Respiratory distress was defined by clinician diagnosis, standard signs, or need for respiratory support at admission or during stay. Data were extracted via a structured form; outcomes analyzed in SPSS v26 using unadjusted odds ratios, 95% CIs, p<0.05. Results: Among 169 NICU admissions, respiratory distress (RD) was present in 96 neonates, with a prevalence 56.80%. RD cases had a mean age of 6.79±3.81 days, were predominantly male (63.54%), mostly preterm (60.42%), and commonly admitted within ≤3 days of life (83.33%). Common causes included CHD (40.6%), neonatal sepsis (35.4%), TTN (32.3%), and RDS (18.8%). Supportive care was frequent; mean NICU stay was 5.6±4.1 days.On unadjusted analysis, TTN (OR 5.88, p = 0.002), RDS (OR 5.65, p = 0.03), and CHD (OR 2.57, p = 0.033) were significantly associated with RD. Conclusion: Respiratory distress affected over half of NICU admissions, mostly within three days, with CHD, EONS/LONS, and TTN as leadin cause. Early evaluation and standardized protocols can optimize oxygen therapy, echocardiography, and antibiotic stewardship.