Pulmonary oedema in newborns | Approximately more than 10% of preterm infants are prone to wheezing, shortness of breath and pulmonary oedema. Meanwhile, around 4–5% of full-term newborns may develop pulmonary oedema. This is usually related to the maturity of the newborn’s lungs.Let us take a look at the explanation provided by paediatric specialist Dr Chen Xinyong on this issue.
Why do newborns get pulmonary water?
Newborns are protected by amniotic fluid in their mother's uterus and do not need to use their lungs to breathe; nutrients are supplied to them from their mother via the umbilical cord. However, after birth, newborns need to start breathing on their own, and their ability to do so successfully typically depends on the maturity of their lungs. Normally, when newborns cry after birth, their lungs begin to function, gradually absorbing the amniotic fluid, and they start breathing smoothly.
However, some newborns may experience "wet lung" due to various reasons, such as underdeveloped lungs or other health issues, which prevent their alveoli from opening sufficiently during breathing and crying. This leads to slow absorption of amniotic fluid and can result in the newborn gasping or breathing rapidly after birth. In severe cases, oxygen support or even mechanical ventilation may be required.
3 Major Factors for Neonatal Pulmonary Edema
1. Premature birth: Babies born before 37 weeks of gestation are prone to pulmonary oedema or shortness of breath due to immature lungs.
2. Caesarean section: Newborns delivered by Caesarean section may be more likely to develop transient tachypnoea of the newborn (TTN) than those delivered vaginally, as they do not experience the normal squeezing process of the birth canal, which can lead to slower absorption of amniotic fluid.
3. Male infants or newborns with a larger birth weight: Male infants or newborns with a larger birth weight may be more prone to developing pulmonary effusion.
It is noteworthy that advanced maternal age, lifestyle, and dietary habits generally do not correlate with neonatal hydrops.
For neonatal pulmonary oedema, in most cases, close observation of the newborn is required to ensure they can recover on their own. This typically includes maintaining a suitable temperature in an incubator and monitoring their respiratory status. In many situations, newborns will gradually return to normal breathing within a few hours and will not require additional treatment.
Does neonatal pulmonary oedema affect future lung function?
It is important to emphasise that neonatal pulmonary oedema usually does not have long-term effects on future lung function and is unlikely to cause other lung conditions, such as pneumonia. The lungs are organs that grow and develop, and temporary problems during the neonatal period do not typically result in long-term consequences.
Preventing premature birth to avoid lung fluid buildup
Finally, one of the best preventative measures for expectant mothers is to try and avoid premature birth, as premature babies are more prone to developing pulmonary effusions. Furthermore, a natural birth may be more beneficial for a newborn's respiration compared to a Caesarean section. In all circumstances, medical advice should be closely followed and appropriate care sought when necessary.
Source: SundayKiss (11 September 2023)
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