Prevalence and Predictors of Infant Mortality of Respiratory Distress Syndrome in Beijing and Jiangxi Provinces of PR China: A Retrospective Cohort Analysis

Like any other countries, respiratory distress syndrome is a major cause of infantile mortality in China, especially in low birth weight infants. The study aimed to determine the incidence of respiratory distress syndrome and identify some predictors of mortality in Chinese infants with confirmed respiratory distress syndrome (Level of Evidence: III). We retrospectively analyzed the demographic characteristics, perinatal risk factors, and clinical manifestations of 600 infants with Downes’ score of ≥ 4 admitted to the Affiliated BaYi Children’s Hospital, China, and the Second Affiliated Hospital of Nanchang University, China, from 1 January 2013 to 1 December 2018. Infants were divided into two cohorts, non-survivors (who died, n = 109) and survivors (who survived, n = 491). Factors predicting infant mortality were determined using univariate and multivariate logistic regression analysis at a 95% confidence level. Infants of the non-survivor cohort were more likely to have severer respiratory distress (P = 0.003), to be of low birth weight (< 1,000 g, P = 0.028), to undergo cesarean delivery (P = 0.005), and to be born preterm (P = 0.0001) than those of the survivor cohort. Downes’ score of > 6, extreme low birth weight (< 1,000 g, P = 0.001), preterm delivery (gestational age < 37 weeks, P = 0.003), and cesarean delivery (P = 0.002) were found to be the independent risk factors of infant death. Preterm delivery, extremely low birth weight, and cesarean section were the risk factors of infant death from respiratory distress syndrome.