Mortality Rate in Preterm Newborns with Respiratory Distress Syndrome (RDS) Due to Surfactant Deficiency Before and After Implementing a Fast-Track Surfactant Administration Protocol at King Narai Hospital.

Abstract

     This study was retrospective aimed to study the mortality rate and the factors associated with mortality before and after the implementation of a fast-track surfactant administration protocol. Conducted on all preterm newborns diagnosed with RDS who were treated under the fast-track surfactant protocol at King Narai Hospital between October 1, 2019, and September 30, 2023. A total of 350 newborns were included. Data collected included basic demographic information, general risk factors, pregnancy-related complications, and surfactant treatment details. Statistical analysis was performed using logistic regression and multiple logistic regression to assess the odds ratios, with a significance level of p < 0.05.
     Results: Out of 350 newborns. A total of 32 newborns (13.4%) died, with the most common cause of death being sepsis (71.8%). The average duration of mechanical ventilation was 18.88±7.18 days, and the average length of hospital stay was 18.64±7.42 days. The average treatment cost was 52,888±45,312.84 THB. Statistically significant factors associated with mortality before and after implementing the fast-track surfactant protocol (p < 0.05) included: Gestational age < 30 weeks (OR 4.98, 95% CI 2.09–11.85) Maternal pre-eclampsia (OR 9.89, 95% CI 2.32–42.04) Cesarean section (OR 2.28, 95% CI 1.99–5.24) Breech presentation (OR 1.05, 95% CI 1.01–4.36)