survival of respiratory failure within the first 72 hours in preterm infants with respiratory distress based on the downes score assessment

Background: respiratory distress in neonates is the most common condition of preterm infants receiving treatment in the neonatal intensive care unit. as a clinical assessment of respiratory distress, the downes score can predict the risk of respiratory failure. the present study aimed to determine the survival of respiratory failure in the first 72 h in preterm infants with respiratory distress based on the downes score assessment. methods: a prospective cohort survival analysis was performed at three hospitals in indonesia (al-islam hospital, bandung, al-ihsan hospital, bandung, and cibabat hospital, cimahi) from april to july 2021. subjects were infants aged 28-36 weeks, with respiratory distress based on the downes score within the first 2, 6, 12, 24, 48, and 72 h after delivery. the analyzed variables included birth weight ([bw], <1500 vs. 1500-2500 g), gestational age ([ga], 28-32 vs. 32-37 weeks), and 5-min apgar score (<7 vs. >7). bivariate and multivariate analyses were conducted with cox regression proportional hazard and the kaplan-meier estimate of survival rate was also performed. in addition, the adjusted hazard ratio (ahr) was calculated, and a p-value of less than 0.05 was considered statistically significant. results: of the 89 subjects who met the criteria, 20 (22.47%) experienced respiratory failure. the multivariate analysis including bw (ahr: 1.846, 95%ci: 0.570-5.979, p> 0.05), ga (ahr: 2.273, 95 %ci: 0.697-7.416, p>0.05), and the 5-min apgar score (ahr: 2.049, 95%ci: 0.811-5.179, p>0.05) estimated the survival rate for respiratory failure at the age of 72 h at 74.7% (standard error: 0.05%). conclusion: a ga of <32 weeks, a bw of <1500 g, and the condition of asphyxia simultaneously increased the ahr of respiratory failure, with an estimated survival rate of 74.7%.