Abstract
BACKGROUND: Neonatal respiratory distress (NRD) remains a major cause of early morbidity and mortality worldwide, accounting for a significant proportion of neonatal intensive care unit (NICU) admissions in developing countries. Understanding the etiological spectrum, clinical interventions, and short-term outcomes is crucial to guide evidence-based neonatal care in resource-limited settings. OBJECTIVE: To evaluate the clinical characteristics, treatment modalities, and immediate outcomes among neonates presenting with early-onset respiratory distress within 72 hours of birth and to assess the influence of antenatal corticosteroid (ACS) exposure on disease severity. METHODS: This prospective observational study included 1000 neonates admitted to the sick newborn care unit (SNCU) at Tirunelveli Medical College and Hospital, Tamil Nadu, India, over one year. Data on maternal, perinatal, and neonatal variables were collected using a structured proforma. Severity was assessed using the Silverman-Anderson and Downe's scores. Statistical analysis included chi-square and ANOVA tests, with p < 0.05 was considered significant. RESULTS: Among 1000 neonates, 56% were male and 56% were term. The major etiologies were transient tachypnea of the newborn (56%), respiratory distress syndrome (39%), and meconium aspiration syndrome (5%). Continuous positive airway pressure (CPAP) was required in 36% of cases, while 58% were managed with oxygen hood therapy. Severe distress occurred predominantly in preterm and low-birth-weight infants. Overall mortality was 1.9%, confined to the extremely preterm group. ACS exposure showed a trend toward lower severity and reduced need for invasive support. CONCLUSION: Early recognition and structured management, including timely CPAP initiation and antenatal corticosteroid use, significantly improve short-term outcomes in neonatal respiratory distress. Strengthening antenatal and neonatal care integration is essential for further mortality reduction in similar healthcare settings.