Predisposing factors, incidence and mortality of pneumothorax in neonates

Aim. Incidence, risk factors, morbidity and mortality of pneumothorax in neonates vary widely. We aimed to evaluate characteristics, predisposing factors and associated primary lung conditions of pneumothorax in neonates. Methods. Neonates diagnosed to have pneumothoraces in a neonatal unit of university teaching hospital between May 2006 and August 2008 were studied. Pneumothorax was defined as accumulation of air in the pleural cavity as confirmed by chest radiograph. Results. A. total of 25 neonates with pneumothorax were studied. Among them, 32% were inborn, 62% were male and 52% were term neonates. Mean birth weight and median gestation were 2336 g and 37 weeks, respectively. Incidence among inborn neonates was 0.27% and among term and preterm, 0.13% and 0.79%, respectively. Incidence among Neonatal Intensive Care Unit admissions was 1.86%. Ten pneumothoraces occurred in neonates receiving ventilation with an incidence of 1.85%. Incidence of pneumothorax among ventilated neonates was not significantly different from nonventilated (P=0.8). About 84% of pneumothorax occurred within 48 hours of life. Pneumothorax was unilateral in 84% and more common on right side. Underlying pulmonary pathology was observed in 72% and included hyaline membrane disease (HMD) in 40%, meconium aspiration syndrome (MAS) in 24% and pneumonia in 8%. Mean intrapleural drainage was 2.5days and 9 neonates died. Conclusion. Incidence of pneumothorax was similar to reports in the literature and higher among preterm than term neonates. HMD and MAS were common underlying lung conditions for neonatal pneumothorax. Incidence among ventilated neonates was lower than other reports.