{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:37:25Z","timestamp":1792291045523,"version":"4.4.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,20]],"date-time":"2019-01-20T00:00:00Z","timestamp":1547942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The management practices of Respiratory Distress Syndrome (RDS) in the newborn have changed over time. We examine the trends in the epidemiology, resource utilization, and outcomes (mortality and bronchopulmonary dysplasia [BPD]) of RDS in preterm neonates \u226434 weeks gestational age (GA) in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective serial cross\u2010sectional study, we used ICD\u20109 codes to classify preterm infants GA \u226434 weeks between 2003 and 2014 from the National Inpatient Sample as having RDS or not. Trends in the prevalence of infants defined as RDS by ICD\u20109 code (ICD9\u2010RDS), length of stay, BPD, and mortality were analyzed using Cochran\u2010Armitage and Jonckheere\u2010Terpstra tests and multivariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1\u2009526\u2009186 preterm live births with GA \u226434 weeks, 554\u2009409 had ICD9\u2010RDS (260 cases per 1000 live births) with the prevalence increasing from 170 to 361 (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001) and associated decrease in all\u2010cause mortality (7.6% to 6.1%; <jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001) from 2003 to 2014. Increased utilization of non\u2010invasive mechanical ventilation (NIMV) (69.5% to 74.3%; <jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001) was associated with decreased invasive mechanical ventilation (IMV) use &gt;96\u2009h (60.4 to 56.6%; <jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001). Exclusive NIMV use increased from 16.8% to 29.1% (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.0001). BPD incidence decreased from 14% to 12.5% (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001). LOS increased from 32 days to 38 days (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001) and cost increased from $49,521 to $55,394 (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>From 2003 to 2014, the assigned ICD9\u2010RDS diagnosis, and utilization of NIMV increased and mortality among infants assigned the ICD9\u2010RDS diagnosis decreased. With higher survival, hospital cost increased incrementally, indicating the importance of ongoing analysis of appropriate reimbursement for the care provided at tertiary centers for preterm infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24241","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T07:15:09Z","timestamp":1548054909000},"page":"405-414","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Trends in epidemiology and outcomes of respiratory distress syndrome in the United States"],"prefix":"10.1002","volume":"54","author":[{"given":"Keyur","family":"Donda","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Neonatology, Miller School of Medicine University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Vijayakanthi","sequence":"additional","affiliation":[{"name":"Division of Neonatology Maimonides Infants and Children's Hospital Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0563-0437","authenticated-orcid":false,"given":"Fredrick","family":"Dapaah\u2010Siakwan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology, Miller School of Medicine University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parth","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Texas Tech University Health Science Center Amarillo Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Albert Einstein College of Medicine New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantanu","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Division of Neonatology Maimonides Infants and Children's Hospital Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1571202"},{"key":"e_1_2_11_3_1","unstructured":"XuJ MurphySL KochanekKD BastianB AriasE.National Vital Statistics Reports Volume 67 Number 5 July 26 2018 Deaths: Final Data for 2016.2018."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2959"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1542\/peds.92.2.191","article-title":"Decreasing mortality associated with the introduction of surfactant therapy: an observational study of neonates weighing 601 to 1300 grams at birth. 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