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Last reviewed: 17 Mar 2025
Last updated: 05 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • signs of postmaturity
  • tachypnea
  • cyanosis
  • chest wall asymmetry with decreased air entry
  • barrel-shaped chest

Other diagnostic factors

  • grunting
  • chest retractions
  • rales
  • rhonchi
  • tachycardia
  • hypotension

Risk factors

  • gestational age >42 weeks
  • pregnancy-induced hypertension
  • maternal diabetes mellitus
  • maternal smoking or substance misuse
  • fetal distress
  • oligohydramnios
  • thick meconium
  • Apgar score <7
  • chorioamnionitis
  • cesarean delivery
  • black ancestry
  • male sex

Diagnostic tests

1st tests to order

  • CXR
  • CBC
  • CRP
  • blood culture

Tests to consider

  • dual pulse oximetry
  • ABG (pH, PaO₂, PaCO₂)
  • echocardiography
  • cranial ultrasound
  • electroencephalogram
  • urinalysis

Treatment algorithm

Contributors

Authors

Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Dharmapuri Vidyasagar

Professor Emeritus

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Visiting Professor

Department of Neonatology

Sri Ramachandra Medical College

Chennai

India

Disclosures

DV is an author of a number of references cited in this topic. He has received royalties for editing the following books: Neonatal Ventilation (Elsevier India), Practical Neonatology (Indian Journal of Pediatrics), and Perinatal Cardiology (Cambridge Scholar publishing).

Rama Bhat, MD, FAAP

Professor of Pediatrics

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Disclosures

RB is an author of a reference cited in this topic.

Peer reviewers

Ahmed Osman, MD

Assistant Professor of Pediatrics

Attending Neonatologist

Department of Pediatrics

The Ohio State University and Nationwide Children’s Hospital

Columbus

OH

Disclosures

AO is an author of a reference cited in this topic.

Henry L. Halliday, MD, FRCPE, FRCP, FRCPCH

Professor

Retired Consultant Neonatologist

Royal Maternity Hospital

Honorary Professor

Department of Child Health

Queen's University Belfast

Belfast

UK

Disclosures

HLH declares that he has no competing interests.

John Sinn, MBBS(Syd), Dip Paed, DCH, MMed (Clin Epi), FRACP (Paed)

Clinical Senior Lecturer

Obstetrics

Gynaecology and Neonatology

Royal North Shore Hospital and The University of Sydney

Sydney

Australia

Disclosures

JS declares that he has no competing interests.

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