Causes of early neonatal respiratory distress in the former Venda--a community-based study.
OBJECTIVE
To determine in a rural black population the incidence of common forms of respiratory distress (RD) and low birth weight (LBW), the mortality from RD and the perinatal mortality rate (PMR).


METHODS
A prospective study in a context in which about 90% of the community's births take place within the health service and unwell neonates are transferred to hospital.


METHODS
The Donald Fraser health ward, Northern Province (then Venda), which serves a population of about 180,000 through 21 clinics and health centres and a 450-bed hospital.


METHODS
7,539 infants born alive between 1 February 1992 and 31 January 1993, of whom 48 developed RD.


METHODS
Hjalmarson's classification of RD, modified for local conditions. Criteria depended on clinical signs, chest radiography, neutrophil count in blood and gastric aspirate, blood cultures and postmortem examination.


RESULTS
RD 6.4/1,000 livebirths (95% CI 4.6-8.2); infection 2.6/1,000 livebirths (95% CI 1.4-3.7); hyaline membrane disease (HMD) 0.9/1,000 livebirths (95% CI 0.2-1.6); pulmonary maladaptation (transient tachypnoea) 0.8/1,000 livebirths (95% CI 0.2-1.4); mortality from RD 2.1/1,000 livebirths (95% CI 1.1-3.2); incidence of LBW 7.9% (95% CI 7.3-8.5); PMR 19.8/1,000 livebirths (95% CI 17-23).


CONCLUSIONS
A strikingly low incidence of neonatal RD in general and of HMD in particular was found in a rural black population, probably related to a low LBW incidence. Infection was the commonest cause of RD.
van Rijswijk
P
P
Donald Fraser Hospital, Vhufuli, Northern Province.
Ingle
R F
RF
D006801:Humans; D006819:Hyaline Membrane Disease / Q000150:complications*; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000150:complications*; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000150:complications*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology* / Q000401:mortality; D012424:Rural Population