title: [Risk factors for developing pneumothorax in full-term neonates with respiratory distress].
abstract: OBJECTIVE
  To describe respiratory distress (RD) in full-term neonates hospitalized in the NICU and to determine risk factors in this population for pneumothorax.
  
  
  METHODS
  Retrospective inclusion for 4 years of full-term neonates hospitalized for RD before the 2nd day of life. Neonates were separated into Group I (RD with no pneumothorax) and Group II (RD with pneumothorax). Data collected from maternal and newborn medical records were obstetrical, perinatal, and postnatal. P<0.05 was set as the significance level.
  
  
  RESULTS
  Ninety-six neonates were included. In this population, 64 (66.7%) were male, 45 (46.9%) were born by cesarean section, and 30 (31.3%) by elective cesarean section. Neonatal outcome was 4.6 days of hospital stay, 47.4% odds of mechanical ventilation, and 17.7% of persistent pulmonary hypertension of the neonate (PPHN). A central catheter was needed in 25% of the patients and amine treatment in 3.1%. The number of neonates born by cesarean section was lower as term increased. Those born by cesarean section were more likely to develop PPHN (26.7 vs 9.8%; P=0.03), and those born without labor were more likely to require oxygen (83.3 vs 63.6%; P=0.05). When comparing Group I and Group II (32 neonates), absence of labor (RR 1.5) and birth outside of a level III maternity unit (RR 1.6) were risk factors for pneumothorax. These results were confirmed in multivariate analysis. In Group II, birth before 39 weeks was a risk factor for bilateral pneumothorax (P=0.01). The median length of hospitalization was significantly longer in Group II than in Group I (5.8 days vs 4 days, P=0.03).
  
  
  CONCLUSIONS
  RD at term exposes the infant to high morbidity and pneumothorax, especially if born outside of a level III maternity unit and absence of labor.
authors.affiliation: Service de néonatologie, hôpital A.-Trousseau, 26, avenue du Dr-Netter, Paris, France. isabellegirard@voila.fr
authors.forename: I
authors.initials: I
authors.lastname: Girard
authors.forename: C
authors.initials: C
authors.lastname: Sommer
authors.forename: S
authors.initials: S
authors.lastname: Dahan
authors.forename: D
authors.initials: D
authors.lastname: Mitanchez
authors.forename: P
authors.initials: P
authors.lastname: Morville
mesh_terms: D002405:Catheterization, Central Venous; D002585:Cesarean Section; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis; D011030:Pneumothorax / Q000175:diagnosis* / Q000209:etiology; D011247:Pregnancy; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000209:etiology; D012151:Resuscitation; D012189:Retrospective Studies; D012307:Risk Factors