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

Background: Like any other countries, respiratory distress syndrome is a major cause of infantile mortality in China, especially in low birth weight infants. Objectives: 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). Methods: 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. Results: 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. Conclusions: Preterm delivery, extremely low birth weight, and cesarean section were the risk factors of infant death from respiratory distress syndrome.