Introduction: Neonatal respiratory distress (NRD) is a main cause of neonatal morbidity
and mortality . Early detection of its risk factors and early treatment of its etiologies are
major challenges in the developing countries. However, few studies in the developing
countries have provided data needed to tackle it.
Aim : this study carried out to determine the admission rate, etiologies, related
intervention and outcome of NRD in Tripoli Medical Center (TMC) as the main referral
center in Tripoli-Libya.
Method: Case series study was carried out from 1st January to 31th March 2010, and was
based on reviewing the hospital files of all newborns admitted to the N.I.C.U. because of
neonatal respiratory distress(NRD) irrespective of to the underlying cause. NRD was
diagnosed based on the presence of one or more of the following signs: an abnormal
respiratory rate, expiratory grunting, nasal flaring, chest wall recessions and thoracoabdominal asynchrony with or without cyanosis These
data included: clinical variables of newborns and their mothers in addition to results of
their investigations . These variables were cross-checked to make sure that they were in
line with the etiology of NRD in the hospital files. The related intervention ,and outcome
were studied. Statistical data were coded and SPSS software was used for analysis.
Result : In the 3 months studied and out of 2815 births ,and 448 newborns admitted in
NICU, there were 337 newborns were admitted in NICU because of NRD giving admission
rate of 11.9% from total births , and 75% from the total number of admission in NICU in
the same period.
The main etiologies of NRD were Transient Tachypnoea of Newborn( TTN) 33.2%,
followed by Respiratory Distress Syndrome ( RDS) 26.4% , then Meconium Aspiration
Syndrome (MAS) 13.1% and Perinatal Asphyxia 12.2% from the total No. of NRD. During
admission period , 11.2% of NRD newborns were managed by mechanical ventilation; and
only 0.6% were intervented by continuous positive airway pressure CPAP; where
surfactant therapy was given to 3% .
During this period the mortality rate of NRD was 11% , which was significantly related to
RDS as it account 66.7% of total deaths (p0.001).Taking in consideration that RDS account
only 26.4% from total admission .
Conclusion: NRD is a frequent emergency and causes high morbidity and significant
mortality. Most of its risk factors and etiologies are preventable. Adequate follow-up during
pregnancy and labor for timely intervention may improve the neonatal outcomes. Overall,
our results emphasize the urgent need of improving obstetric care , equipping neonatal care

units by noninvasive ventilatory support measures like CPAP machines ,and availability of
surfactant.