Am J Perinatol 2019; 36(10): 1090-1096
DOI: 10.1055/s-0038-1676490
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Time to Neonatal Transport on Outcomes of Transient Tachypnea of the Newborn

Katsuya Hirata
1   Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
,
Masatoshi Nozaki
1   Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
,
Narutaka Mochizuki
1   Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
,
Shinya Hirano
1   Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
,
Kazuko Wada
1   Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
› Author Affiliations
Funding None.
Further Information

Publication History

28 August 2018

28 October 2018

Publication Date:
14 December 2018 (online)

Abstract

Objective To assess effects of neonatal transport on transient tachypnea of the newborn (TTN) in outborn term neonates.

Study Design This retrospective cohort study included 66 term neonates diagnosed with TTN and transported to the Osaka Women's and Children's Hospital neonatal intensive care unit between January 2003 and March 2018. A multivariate logistic regression analysis identified perinatal and neonatal transport factors associated with adverse short-term outcomes defined as mechanical ventilation >48 hours, continuous positive airway pressure >72 hours, pulmonary hemorrhage, and requirement for inhaled nitric oxide, thoracentesis, or surfactant replacement therapy.

Results A lower gestational age (GA) (37.7 [37.2, 38.3] vs. 39.6 [37.8, 40.3] weeks, p = 0.002), longer time to neonatal transport (10.0 [4.3, 25.5] vs. 5.5 [2.7, 9.7] hours, p = 0.01), and higher respiratory rates during transport (70 [60, 85] vs. 60 [55, 78.8] breaths/min, p = 0.04) were significantly associated with adverse short-term outcomes. After adjusting for GA, sex, cesarean section, and time to neonatal transport, GA (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.24–0.87) and time to neonatal transport (OR, 1.07; 95% CI, 1.01–1.13) were significantly associated with adverse outcomes.

Conclusion Short-term adverse prognosis of TTN is strongly associated with a lower GA and longer time between birth and neonatal transport.

Authors' Contributions

K.H. conceptualized and designed the study, contributed to the data analysis, and drafted the article. M.N., N.M., S.H., and K.W. reviewed the study results and gave conceptual suggestions. All authors reviewed the draft article and approved the final article for publication.


 
  • References

  • 1 Jensen EA, Lorch SA. Effects of a birth hospital's neonatal intensive care unit level and annual volume of very low-birth-weight infant deliveries on morbidity and mortality. JAMA Pediatr 2015; 169 (08) e151906
  • 2 Marlow N, Bennett C, Draper ES, Hennessy EM, Morgan AS, Costeloe KL. Perinatal outcomes for extremely preterm babies in relation to place of birth in England: the EPICure 2 study. Arch Dis Child Fetal Neonatal Ed 2014; 99 (03) F181-F188
  • 3 Hohlagschwandtner M, Husslein P, Klebermass K, Weninger M, Nardi A, Langer M. Perinatal mortality and morbidity. Comparison between maternal transport, neonatal transport and inpatient antenatal treatment. Arch Gynecol Obstet 2001; 265 (03) 113-118
  • 4 Gowen Jr CW, Lawson EE, Gingras J, Boucher RC, Gatzy JT, Knowles MR. Electrical potential difference and ion transport across nasal epithelium of term neonates: correlation with mode of delivery, transient tachypnea of the newborn, and respiratory rate. J Pediatr 1988; 113 (1 Pt 1): 121-127
  • 5 Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol 1995; 102 (02) 101-106
  • 6 Tutdibi E, Gries K, Bücheler M, Misselwitz B, Schlosser RL, Gortner L. Impact of labor on outcomes in transient tachypnea of the newborn: population-based study. Pediatrics 2010; 125 (03) e577-e583
  • 7 Gross Sr TL, Sokol RJ, Kwong MS, Wilson M, Kuhnert PM. Transient tachypnea of the newborn: the relationship to preterm delivery and significant neonatal morbidity. Am J Obstet Gynecol 1983; 146 (03) 236-241
  • 8 Rawlings JS, Smith FR. Transient tachypnea of the newborn. An analysis of neonatal and obstetric risk factors. Am J Dis Child 1984; 138 (09) 869-871
  • 9 Riskin A, Abend-Weinger M, Riskin-Mashiah S, Kugelman A, Bader D. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key. Am J Perinatol 2005; 22 (07) 377-382
  • 10 Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ 2008; 336 (7635): 85-87
  • 11 Mori R, Fujimura M, Shiraishi J. , et al. Duration of inter-facility neonatal transport and neonatal mortality: systematic review and cohort study. Pediatr Int 2007; 49 (04) 452-458
  • 12 Yuda M. Public and social environment changes and caesarean section delivery choice in Japan. BMC Res Notes 2018; 11 (01) 633
  • 13 Machado LU, Fiori HH, Baldisserotto M, Ramos Garcia PC, Vieira AC, Fiori RM. Surfactant deficiency in transient tachypnea of the newborn. J Pediatr 2011; 159 (05) 750-754
  • 14 Kasap B, Duman N, Ozer E, Tatli M, Kumral A, Ozkan H. Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008; 50 (01) 81-84
  • 15 Hiroma T, Ichiba H, Wada K, Shiraishi J, Sugiura H, Nakamura T. Nationwide survey of neonatal transportation practices in Japan. Pediatr Int (Roma) 2016; 58 (04) 311-313
  • 16 Alvarado-Socarras J, Bermon A, Bernal N, Naranjo-Estupiñán NF, Idrovo AJ. Intra-hospital mortality among neonates transported by ambulance in Colombia. Pediatr Int 2014; 56 (04) 571-576
  • 17 Okoroh EM, Kroelinger CD, Lasswell SM, Goodman DA, Williams AM, Barfield WD. United States and territory policies supporting maternal and neonatal transfer: review of transport and reimbursement. J Perinatol 2016; 36 (01) 30-34
  • 18 Celebi MY, Alan S, Kahvecioglu D. , et al. Impact of prophylactic continuous positive airway pressure on transient tachypnea of the newborn and neonatal intensive care admission in newborns delivered by elective cesarean section. Am J Perinatol 2016; 33 (01) 99-106
  • 19 Gizzi C, Klifa R, Pattumelli MG. , et al. Continuous positive airway pressure and the burden of care for transient tachypnea of the neonate: retrospective cohort study. Am J Perinatol 2015; 32 (10) 939-943
  • 20 Aherne W, Dawkins MJ. The removal of fluid from the pulmonary airways after birth in the rabbit, and the effect of this on prematurity and pre-natal hypoxia. Biol Neonat 1964; 7: 214-229
  • 21 Katz C, Bentur L, Elias N. Clinical implication of lung fluid balance in the perinatal period. J Perinatol 2011; 31 (04) 230-235
  • 22 Helve O, Janér C, Pitkänen O, Andersson S. Expression of the epithelial sodium channel in airway epithelium of newborn infants depends on gestational age. Pediatrics 2007; 120 (06) 1311-1316
  • 23 Bland RD, Bressack MA, McMillan DD. Labor decreases the lung water content of newborn rabbits. Am J Obstet Gynecol 1979; 135 (03) 364-367