Respiratory Difficulty in Premature Babies

According to statistics, one of the most common issues faced by premature babies is respiratory difficulty. It is found in 2-3% of all newborns; in 50% of babies born before 30 weeks, and in 20% of babies with a birth weight of less than 2,500 grams. Experts at Anadolu Medical Center remind that respiratory difficulty can occur not only in premature babies but in all newborns. They say, "The frequency of respiratory difficulty in cesarean deliveries is twice as high as in normal deliveries."

What is Preterm Birth?

Preterm birth is defined as the birth of a baby before the 37th week of pregnancy. Studies show that in Turkey, 8 out of every 100 babies are born prematurely. While preterm birth can lead to some complications in babies, respiratory difficulty is one of the primary concerns. Respiratory difficulty is not exclusive to preterm babies and can be observed in all babies for various reasons. In addition to lung-related issues, causes such as upper respiratory tract obstructions, congenital heart diseases, excessive red blood cells, anemia, metabolic problems, infections, meningitis, and intracranial hemorrhages can also lead to respiratory difficulties.

Symptoms of Respiratory Difficulty

Symptoms include a respiratory rate higher than normal, ranging from 20-40 breaths per minute, chest retractions, nostril flaring, grunting, skin discoloration (bluish), and intermittent cessation of breathing. Babies experiencing respiratory difficulty may also show signs of reluctance to suck, weakness, and restlessness.

Cesarean Delivery Increases the Risk of Respiratory Difficulty

The likelihood of encountering respiratory difficulty varies depending on the mode of delivery. During a normal delivery, the baby is in an amniotic fluid environment in the mother's womb. The baby swallows this fluid continuously, filling the lungs with water. As the baby passes through the birth canal, the chest is compressed, and some of the fluid is expelled from the lungs. The remaining fluid is absorbed through the lymphatic vessels in the lungs. In cesarean deliveries, however, since the mother’s labor has not yet begun and there are no hormonal changes, the fluid in the lungs has not decreased. The baby enters the birth process with excess fluid in the lungs and cannot expel it as it does not pass through the birth canal. Therefore, the lungs are unable to expand properly, resulting in respiratory difficulty. This issue can also be observed in normal deliveries, but in terms of frequency, it is approximately twice as common in cesarean deliveries.

Which Babies Are at Risk of Respiratory Difficulty?

Premature babies, babies of diabetic mothers, those born by cesarean section, babies who have inhaled their first stool into their airways while in the womb, and babies with a family history of respiratory issues are at risk of respiratory difficulty. In some families, even full-term babies may experience respiratory difficulty due to genetic deficiencies in surfactant proteins.

Temporary Respiratory Difficulty Can Be Treated in 2 to 5 Days

In most cases, babies with temporary respiratory difficulty improve within 2 to 5 days. If there are other issues with the lungs, respiratory support may be needed. During treatment, the missing surfactant substance is administered to the lungs through a tube inserted into the airway. During these procedures, intravenous access is established to feed the baby, and fluids are given via the umbilical cord catheter. Since these treatments increase the risk of infection, antibiotics are also recommended.

If There Is a Risk, Neonatal Intensive Care Becomes Crucial

Various factors that could lead to respiratory difficulties can be investigated before birth. In cases where the mother has diabetes, the baby is large, there is a threat of preterm birth, or there are congenital heart diseases, it is essential for these deliveries to take place at centers with neonatal intensive care units. This helps reduce infant mortality and minimize potential future complications.

Last Updated Date: 11 June 2015

Publication Date: 06 November 2015