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The high-risk pregnancy and delivery factors in the newborn pneumonia

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69

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The high-risk pregnancy and delivery f a c t o r s in the newborn pneumonia

W. G r z y w n a , M . D . , K . K o z l o w s k i , M . D . , Anna Wylot-Jonczyk, M . D . Among 248 newborn babies treated because of pneumonia in

Neonatal Pathology Clinic in Z a b r z e from September 1980 to August 1983 there were 129 ( 5 2 % ) f u l l term AGA, 14 ( 5 , 7 % )

f u l l term SFD, 94 ( 3 7 , 9 % ) prematures AGA, 6 ( 2 , 4 % ) prematures SFD, post term AGA 4 ( 1 . 6 % ) and post term SFD 1 ( 0 , 4 % ) . The sick neonates were divided into three groups according to the onset of symptoms of pneumonia (Fig. 1). There were 87

( 3 5 , 0 % ) infants in whom symptoms begun in the f i r s t day of their l i f e (group 1 ) , 6 3 ( 2 5 , 5 % ) i n f a n t s s t a r t e d pneumonia between the second and the seventh day of l i f e

(group II) and 98 ( 3 9 , 5 % ) neonates started pneumonia a f t e r seventh day of their l i f e (group I I I ) . H i g h - r i s k p e r i n a t a l f a c t o r s were ob- served in 73 ( 8 4 % ) from group I , 4 5 ( 7 1 , 4 % ) i n f a n t s from group II and 59 ( 6 0 , 2 % ) neonates from group I I I .

In the f i r s t group h i g h - r i s k perinatal factors were

shown on h i g h - r i s k pregnan- cy in 6 ( 6 , 9 % ) c a s e s , high- risk delivery in 39

cases and of these

cases. In the second group 50%

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Fig. 1. The results of treatment according to the time of onset of pneumonia (see text)

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high risk pregnancy was observed in 3 ( 4 , 8 % ) m o t h e r s , high- risk delivery in 22 ( 3 4 , 9 % ) mothers and the combination of these two in 20 ( 3 1 , 7 % ) m o t h e r s . In the third group there were 11 ( 1 1 , 2 % ) , 31 ( 3 1 , 6 % ) and 17 ( 1 7 , 3 % ) cases in" each sub-

group respectively. The treatment included broad spectrum antibiotics according to antibiograms and oxygen therapy. 71

( 2 8 , 9 % ) newborns s u f f e r i n g from pneumonia were treated by

mechanical ventilation - in the f i r s t group 29 ( 4 0 . 8 % ) infants from which 21 ( 7 2 , 5 % ) died, in the second one 27 ( 3 8 , 0 % ) in- fants from which 9 ( 6 0 , 0 % ) died.

In the f i r s t group 35 ( 4 5 , 2 % ) of the examined newborns died, in the second group 31 ( 4 9 , 2 % ) newborns died and in the third group 16 ( 1 6 , 3 % ) newborns died. Perinatal high-risk factors were observed iii 33 ( 4 5 , 2 % ) dead newborns from the f i r s t group

in 20 ( 4 4 , 0 % ) dead newborns from the second group and in 9 ( 1 5 , 2 % ) dead newborns in the third group (Fig. 2)

Early diagnosis and intensive treatment of neonatal pneumonia are especially needed in cases of h i g h - r i s k pregnancy and

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delivery with the onset of symptoms in the

f i r s t week of newborn1s life t o ' o b t a i n good results.

Fig. 2. The results of treatment according to perinatal high-risk f a c t o r s .

(A - h i g h - r i s k , B - without high- risk)

Neonatal Pathology Clinic, 41-800 Z a b r z e , u l . 3-go Maja 13 Poland

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