Abstract

Background: Neonatal Respiratory Distress Syndrome (NRDS) is a significant clinical condition that primarily affects neonates, particularly preterm infants. It is characterized by insufficient surfactant production, leading to reduced lung compliance, atelectasis (a condition characterized by the complete or partial collapse of the lungs or a section or lobe of the lung.), and impaired gaseous exchange.

Reducing the occurrence of Neonatal Respiratory Distress (NRD) is the global concern. As its occurrence leads to higher neonatal mortality and morbidity. Worldwide, neonatal respiratory distress syndrome rate continues to amplify and interventions to reduce it’s complications have shown great success. Identifying the underlying factors that causes the continued rise could improve the efficacy of interventions. Therefore; this document seeks to review the risk factors associated with Neonatal Respiratory Distress Syndrome, complications and the role of the midwife in managing patients with the condition.

Aim: To determine the prevalence of respiratory distress syndrome, identify risk factors, and review outcomes of neonatal respiratory distress management in affected patients at the Buea Regional Hospital.

Materials and Method: A retrospective hospital based study of medical files of neonates was conducted at the hospital neonatal and pediatric unit at the Buea Regional Hospital from first January 2020 to thirty first December 2024.

Results: The overall prevalence of neonatal respiratory distress was 6.3%. A total 2165 neonatal admissions from 2020 to 2024. With the highest prevalence of 14.9% recorded in 2024. Key risk factors included; low birth weight (LWB) (48.1%), jaundice (25.5%), meconium aspiration (11.7%), prematurity (66.9%), neonatal sepsis(48.3%), birth asphyxia (40.1%), multiple pregnancy(24.1%), infections(16.8%), PROM(12.4%).

Conclusion: The prevalence of neonatal respiratory distress at the Buea Regional Hospital varies yearly and the overall prevalence was 6.3% among 2,165 neonatal admissions from 2020 to 2024. Neonates with birth asphyxia and those born prematurely had a higher risk of developing respiratory distress syndrome. Infants born to mothers who had pre-eclampsia and mothers who experienced PROM had significantly higher odds of developing respiratory distress syndrome.  A majority of infants with neonatal distress under management were successfully discharged, 13.14% died and 11.7% were taken away from the hospital against medical advice.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Respiratory Distress Syndrome (RDS) also known as hyaline membrane disease, is a condition that mostly affects new born premature babies caused by insufficient production of pulmonary surfactants. This deficiency causes the alveolar to collapse, impaired gaseous exchange and respiratory failure shortly after birth. Clinically, it presents with signs of respiratory distress such as; tachypnea, grunting, nasal flaring, chest retraction and cyanosis [1].

Neonatal respiratory Distress (NRD) is the main cause of mobility and mortality among neonates in developing countries. Early detection of its risk factors and treatment of its causes are the major challenges [2]. NRDS occurs frequently as an emergency for neonates worldwide with a prevalence rate of 4.24% in Pakistan [3], 18.5% in France [4]. 14.5% in Burkina Faso [5].  In Cameroon, the general hospital team, Tochie. 2016 [2], was reported respiratory distress was represented the main cause of admission of neonates (47.5%) in the neonatal care unit [2].

Some risk factors increases how susceptible neonates are to respiratory distress diseases such as; prematurity, meconium aspiration, caesarian section delivery, gestational diabetes, maternal chorioamnionitis, and prenatal ultrasonography findings such as: oligohydramnios and structural lungs disorders [6,7].  Regardless of the etiologies, if respiratory distress is not recognized and managed faster, respiratory disease can progress to respiratory and cardiopulmonary arrest. Decrease gestational age exposes one to respiratory distress and there are three more chances of developing respiratory distress at 37 of gestation than at 39-40 weeks [8].

A wide variety of pathologic lesions could be the cause of respiratory disturbances, including pulmonary, airway, cardiovascular, central nervous system, infections, and other disorders [9].  Regardless of the underlying causes, neonatal respiratory distress (NRD) has been reported to be a contribution to a poor neonatal outcome particularly in developing countries [10,11]. According to World Health Organization (WHO), It is estimated 3% of 120 million children born each year in developing countries presents respiratory distress at birth and requires resuscitation [12].

1.2 Statement of Problem

Respiratory Distress Syndrome (RDS) remains a leading cause of morbidity and mortality among neonates, particularly preterm infants. A study by Tochie (2016) at Douala General Hospital reported a high prevalence of 47.5% [2], underscoring the significant burden of RDS in the region. However, there is a lack of recent studies and updated data on RDS in the Buea Regional Hospital, limiting current understanding of its impact in this setting. This study soughts to update statistics on the prevalence and characteristics of RDS among neonates at Buea Regional Hospital, which is essential for improving clinical care and guiding effective interventions.

1.3  Rationale

Neonatal Respiratory distress syndrome (NRDS) is a leading cause of illness and death in newborns, especially in preterm infants. Despite medical advances, RDS remains a major challenge in low resource settings due to limited access to surfactant therapy and respiratory support. Understanding its prevalence, risk factors and outcomes is crucial for improving early diagnosis and management. This study aimed to provide detailed epidemiological data to guide clinical care. It also sought to identify modifiable factors to reduce mortality. Ultimately, the findings will support better health policies and neonatal care strategies.

1.4 Research Questions

1. What is the prevalence of neonatal RDS at the Buea Regional Hospital (BRH)?
2. What are the risk factors associated with neonatal RDS?
3.  What are the management outcomes of neonates with RDS?

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