Severe respiratory distress in term infants born electively at high altitude

BACKGROUND We studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude. METHODS We prospectively studied the charts of term babies born in Taif Maternity Hospital (1640 m above sea level) between 1/1/2004 and 31/10/2004 who developed RDS and required mechanical ventilation. RESULTS 8634 deliveries occurred from 37-<41 weeks; 13 (0.15%) had RDS requiring mechanical ventilation. Seven infants delivered at 37-<38 weeks, (OR for RDS = 26 95%CI -4.6 to 5.8), five delivered at 38-<39 weeks, (OR for RDS = 10 95%CI -4.9 to 5.4) and one delivered at >39 weeks. Six of 13 infants were electively delivered without documented lung maturity. CONCLUSION Infants born at 37 and 38 weeks' gestation remain at significantly increased risk for severe RDS. Elective delivery is responsible for 50% of the potentially avoidable cases. Our data suggest that the altitude does not seem to influence the incidence of severe RDS in term infants born electively.