Respiratory distress in neonates with gestational age ≥ 35 weeks and associations between risk factors & respiratory distress

This study aimed to determine the incidence of respiratory distress among neonates ≥ 35 weeks gestational age requiring respiratory support and identify associated risk factors. A retrospective study at Al Wakra Hospital, Qatar, from January to December 2022, included neonates born at 35 weeks or later admitted to the NICU with respiratory distress requiring support. During the study period, a total of 1194 out of 5637 (21.2%) neonates were admitted to the NICU for various reasons, of which 1062 (18.8%) were born at ≥ 35 weeks of gestational age. Among them, 485/5637 (8.6%) neonates were admitted to the NICU for respiratory distress and received respiratory support, with 442/5637 (7.84%) neonates included in the final analysis after applying the inclusion and exclusion criteria. The incidence of respiratory distress was highest in 35 weeks, with a progressive decline up to 39 weeks, followed by an increase. On adjusted analysis, significant predictors for respiratory distress included gestational age, cesarean delivery, instrument use, sex, fetal distress, meconium-stained liquor, 5-minute Apgar score, and resuscitation. Respiratory distress is a common cause of NICU admission among neonates with a gestational age of ≥ 35 weeks (8.6%). The incidence of respiratory distress was highest at 35 weeks, with a progressive decline up to 39 weeks, followed by an increase. Therefore, if possible, delaying delivery up to 39 weeks could be a good strategy to reduce respiratory distress in neonates with a gestational age of ≥ 35 weeks.