Maternal Oncological Disease and Congenital Pneumonia Are New Independent Risk Factors for Surfactant Requirements in Late Preterm Infants.

Abstract

Aim: The purpose of this study was to evaluate the incidence of respiratory distress syndrome (RDS) in late preterm (LPT) infants. We also aimed to identify the risk factors associated with surfactant requirement and the clinical outcomes associated with surfactant therapy.

Methods: We retrospectively analysed data from a single-centre neonatology unit at the Fondazione Policlinico Universitario Agostino Gemelli, IRCCS in Rome, Italy over a 4 year period. For each risk factor, the odds ratio (OR) and the 95% confidence interval (95% CI) were reported.

Results: The incidence of RDS among 1335 LPT infants was 7.8%. The percentage of infants who required the surfactant was 3.4%. Gestational age (OR 0.541, 95% CI 0.367-0.796, p = 0.002), birth weight (OR 1.001, 95% CI 1.000-1.003; p = 0.037), 1 min Apgar score (OR 0.631, 95% CI 0.440-0.905, p = 0.012) and congenital pneumonia (OR 28.931, 95% CI 9.139-91.597, p < 0.001) were the neonatal risk factors associated with surfactant requirement. Oncological disease (OR 4.116, 95% CI 1.081-15.672, p = 0.038) was the maternal risk factor associated with surfactant requirement.

Conclusions: Maternal oncological disease and congenital pneumonia emerged as new risk factors for surfactant requirement in LPT infants. These findings expanded the understanding of the mechanisms underlying RDS in LPT infants, moving beyond the known risk factors.