Respiratory distress due to surfactant deficiency in a third-level hospital with no in-patient deliveries: mortality-related factors

Background. Surfactant deficiency is a frequent cause of respiratory distress in the preterm newborn. The aim of this study is to determine the factors associated with mortality. Methods. We studied 257 cases in a tertiary-care neonatal intensive care unit with no in-hospital deliveries. We compared survivors and deaths with the χ 2 test and calculated odds ratio and 95% confidence interval. We subdivided the cases at 1500 g searching for any differences. Results. Of the newborns, 60% were male. Mean birth weight was 1 666 g and gestational age was 31 weeks. In only 9% was there pulmonary maturation induction with steroids. Overall mortality was 30%. Statistical differences were found between live newborns and deaths according to mean birth weight (1 812 g vs. 1321 g, p <0.001) and gestational age (32 vs. 29 weeks, p <0.001). Associated risk factors were maternal diabetes (OR 9.8, 95% CI: 1-89) and threatened abortion (OR 13.2; 95% CI: 2.8-62). There was no difference between those babies who received or did not receive surfactant or whether it was received before or after 3, 6 or 12 h. Conclusions. Mortality due to surfactant deficiency was high, especially among lower birth weight infants. Surfactant did not lower mortality in this group.