이 문서는 의학지식을 포함하고 있습니다. 의학은 빠르게 변화하는 학문으로 아래의 내용은 최신의 정보가 아닐 수 있으며, 따라서 글을 읽는 시점에는 정확한 내용이 아닐 수 있습니다. 이 내용에 따라 스스로 질병을 진단하거나 치료하려 하지 마십시오. 질병의 정확한 진단과 치료를 위해서는 의사의 진료가 필수적입니다. 이 내용은 의학적 상식을 넓히기 위한 용도로 사용하십시오.
신생아 호흡기 질환과 신생아 사망의 가장 흔한 원인이다. 주로 미숙아에서의 폐의 발달 미숙으로 인한 폐표면활성제(surfactant)의 부족에 의해 발생된다고 알려져 있으며, 발생빈도는 임신주수와 출산시 체중에 반비례한다. 1)
하지만 전체 RDS의 6.8%는 만삭 혹은 거의 만삭에 출생한 아이에서 발생한다는 보고가 있다. 2)
전반적인 폐포의 무기폐 (atelec tasis)와 폐 부종, 세포손상 등을 특징으로 한다.
Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. It was believed that RDS is mainly found in premature infants, the risk of developing into RDS increased with decreasing of gestational age and birth weight; the incidence rate is 80% in infants <28 weeks gestation, 60% at 29 weeks, and 15–30% at 32–34 weeks, but declined with maturity to 5% at 35–36 weeks and is almost 0% by 39 weeks gestation [1].Accordingly, it is estimated that the incidence rate of RDS is at 80% for infants weighing <750 g at birth and 55% for infants weighing 750–1000 g [2]. However, greater awareness of RDS has led to its more frequent diagnosis in term neonates [3-5], such as Bouziri et al. [4] found that RDS accounted for 6.8% of cases of respiratory distress in term or near-term infants. However, the clinical characteristics, diagnostic criteria and treatment strategies of term neonatal RDS are very different from that in premature infants, all of these will be discussed here. Possible Causes The possible reasons associated with full-term neonatal RDS may be as following: (1) Severe perinatal acquired infections (severe pneumonia and/or septicemia): this is the most common cause of term neonatal RDS. (2) Elective caesarean sections: it has been well documented that the increasing risk of serious respiratory morbidity was associated with decreasing gestational age [6]. It has been suggested that relative surfactant deficiency was the main cause of RDS in elective caesarean birth infants, because of their relatively early gestational age. (3) Severe birth asphyxia and meconium aspiration syndrome (MAS). (4) Pulmonary hemorrhage. (5) Inherited disorders of surfactant metabolism are a rare cause of respiratory disease in newborns but are associated with significant morbidity and mortality [7]. Classification for Term Neonatal RDS Full-term neonatal RDS can be divided into three types, they are as following: (1) Acute respiratory distress syndrome (ARDS): which follows a catastrophic pulmonary or non-pulmonary event, such as asphyxia, meconium aspiration, shock, sepsis and disseminated intravascular coagulation. (2) Idiopathic respiratory distress syndrome (IRDS): Mainly was seen in selective cesarean section babies. The earlier the cesarean section was performed, the higher the incidence of RDS in full-term neonates was [6,8-10]. (3) RDS with relating to inherited surfactant disorders: Inherited disorders of surfactant metabolism is a rare condition but associated with significant morbidity and mortality [11,12