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Clinical–radiological profile and risk factors for early mortality in preterm neonates with respiratory distress syndrome in Hoima, Western Uganda

Year: 2025

Type: article

Abstract: Respiratory distress syndrome (RDS) is the leading cause of respiratory failure and neonatal mortality, particularly in preterm infants. Despite global advances in neonatal care, RDS remains a significant problem in low-resource settings such as Uganda, where limited evidence exists on clinical profiles, mortality, and associated risk factors. Although these advances have greatly reduced mortality in high-income settings, their limited availability in Uganda contributes to the continued high burden of RDS-related deaths. To determine the clinical-radiological profile, early mortality, and risk factors for mortality among preterm neonates admitted with RDS at Hoima Regional Referral Hospital. A prospective cohort study was conducted among 150 preterm neonates with clinically and radiologically confirmed RDS. Data on sociodemographic, clinical, and obstetric characteristics were collected using structured questionnaires and chest X-rays. Participants were followed for seven days to determine outcomes. Descriptive statistics summarized baseline characteristics, while Poisson regression identified independent predictors of mortality. Of the 150 neonates, 62.7% were male and 70.7% were born before 32 weeks of gestation. Tachypnea (84.7%) and intercostal/subcostal retractions (71.3%) were the most frequent clinical features, while ground-glass patterns were the predominant radiological finding. Twenty-nine neonates died within the first seven days, giving an early mortality rate of 19.3%. Independent predictors of mortality were delayed presentation beyond six hours of life (aRR = 1.72, 95% CI: 1.43-2.07, p < 0.001) and birth weight < 1.5 kg (aRR = 1.12, 95% CI: 1.02-1.22, p = 0.015). RDS contributes substantially to early neonatal mortality in Uganda. Prompt recognition, early referral, and improved neonatal care-particularly for very low birth weight infants-are critical to improving outcomes. Although not directly measured in this study, improving access to antenatal corticosteroids and respiratory support-well-established interventions-remains essential for broader improvement of RDS outcomes.

Source: Scientific Reports

DOI: 10.1038/s41598-025-31626-6