Incidence, Etiologies, and Outcomes of Respiratory Distress in Newborns Admitted to the Neonatal Intensive Care Unit of a Tertiary Care Teaching Hospital in Rural South-West Bihar.

Background One of the most frequent reasons for neonatal intensive care unit (NICU) hospitalization is respiratory distress, which causes significant early neonatal morbidity and mortality, especially in resource-constrained environments. Etiology and related risk factors need to be identified early to enhance the outcome of neonates. The aim of the study was to establish the prevalence, etiology, and prognosis of respiratory distress in infants admitted to the NICU of a tertiary care teaching hospital in rural South-West Bihar. Methods This is a prospective observational study, which was carried out in the level III NICU of a tertiary care teaching hospital during 18 months (April 2021-September 2022). Neonates between 0 and 28 days of age who were hospitalized with clinical manifestations of respiratory distress were all included. Maternal and neonatal histories were documented in detail. The severity was determined using the Downe's score on term neonates and the Silverman-Anderson score on preterm neonates. Relevant radiological and laboratory inquiries were conducted to ascertain the etiology. Statistical Package for Social Sciences (SPSS) version 27 (IBM Corp., Armonk, NY) was used to analyze the data, and descriptive statistics was obtained. Results A total of 110 neonates with respiratory distress were enrolled. Male neonates constituted 60% of cases. The majority (62%) presented within the first 24 hours of life. Cesarean section accounted for 54.5% of deliveries, and 67.3% were inborn. Moderate respiratory distress was observed in 45.4% of neonates, while 31% had severe distress. Transient tachypnea of the newborn (TTN) was the most common etiology, followed by perinatal asphyxia and respiratory distress syndrome (RDS). Significant associations were observed between etiology and gestational age, birth weight, and need for resuscitation at birth. Overall, 82.7% of neonates were discharged successfully, while the mortality rate was 8.3%. Conclusion Respiratory distress remains a major cause of NICU admissions in rural tertiary care settings. Transient tachypnea of the newborn was the most common cause, with prematurity and low birth weight being significant risk factors. Early recognition, prompt management, and improved perinatal care can significantly enhance neonatal survival outcomes.