{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:54:08Z","timestamp":1792151648233,"version":"4.4.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory distress is a frequent complication in preterm infants, often requiring respiratory support. Respiratory distress syndrome (RDS), caused by surfactant deficiency in the immature lung, is the predominant etiology in this population. Continuous positive airway pressure (CPAP) is a common intervention, but the optimal timing of CPAP initiation remains less clearly defined in the late preterm population (33\u201336 weeks gestation). This study aimed to determine the outcomes of preterm newborns with respiratory distress in relation to the timing of CPAP initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study was conducted at a tertiary NICU in central India and enrolled 170 preterm newborns (gestational age 28\u201336 weeks, birth weight &lt;1800\u00a0g) with respiratory distress over 18 months. Infants were categorized as Early CPAP (initiated within 30 min of birth, n = 121) or Late CPAP (after 30 min, n = 49). Primary outcome was need for mechanical ventilation; secondary outcomes included mortality, CPAP duration, surfactant use, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mortality rate was lower in the early CPAP group compared to the late CPAP group (13.2% vs 24.5%), though this difference did not reach statistical significance on unadjusted analysis (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 3.218, p = 0.073). After adjustment for gestational age and disease severity, early CPAP initiation was independently associated with lower odds of mortality (aOR = 0.34, 95% CI: 0.13\u20130.89, p = 0.027). Median CPAP duration was significantly longer in the early CPAP group (48.0 vs 24.0 h; p = 0.027). Length of hospital stay was also significantly longer (14 vs 8 days; p = 0.014), while mechanical ventilation duration did not differ significantly (p = 0.140).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early CPAP initiation in preterm newborns with respiratory distress was associated with lower mortality after adjustment for gestational age and disease severity, although the unadjusted analysis was not statistically significant. These findings suggest a potential benefit of early CPAP initiation in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798261443957","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:24:58Z","timestamp":1776752698000},"page":"642-651","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcome of preterm newborns admitted with respiratory distress in relation to time of initiation of CPAP"],"prefix":"10.1177","volume":"19","author":[{"given":"Kaustubh","family":"Pandey","sequence":"first","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharati","family":"Choubey","sequence":"additional","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishtha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Dashore","sequence":"additional","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmila","family":"Ramteke","sequence":"additional","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjusha","family":"Goel","sequence":"additional","affiliation":[{"name":"Gandhi Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2016.03.045"},{"key":"e_1_3_5_3_2","volume-title":"In: StatPearls [Internet]","author":"Yadav S","year":"2025","unstructured":"Yadav S, Lee B. Neonatal respiratory distress syndrome. In: StatPearls [Internet]. Treasure Island (FL):: StatPearls Publishing, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560779\/."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resplu.2022.100320"},{"issue":"5","key":"e_1_3_5_5_2","first-page":"409","article-title":"Bubble CPAP - a primary respiratory support for respiratory distress syndrome in newborns","volume":"46","author":"Urs PS","year":"2009","unstructured":"Urs PS, Khan F, Maiya P. Bubble CPAP - a primary respiratory support for respiratory distress syndrome in newborns. Indian Pediatr 2009; 46(5): 409\u2013411.","journal-title":"Indian Pediatr"},{"issue":"4","key":"e_1_3_5_6_2","first-page":"89","article-title":"Assessment of outcome of preterm infants with respiratory distress on CPAP","volume":"8","author":"Mittal P","year":"2020","unstructured":"Mittal P, Kumar V. Assessment of outcome of preterm infants with respiratory distress on CPAP. J Adv Med Dent Sci Res 2020; 8(4): 89\u201393.","journal-title":"J Adv Med Dent Sci Res"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911783"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072788"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2131"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210904"},{"key":"e_1_3_5_11_2","unstructured":"Jyothi KA Sulthana SAS Ramadevi GV. Use of early labour room bubble CPAP in preterms born at 28-32 weeks of gestation [Internet]. 2018 [cited 2025 Feb 15]. Available from: https:\/\/imsear.searo.who.int\/handle\/123456789\/185047"},{"issue":"5","key":"e_1_3_5_12_2","first-page":"28","article-title":"Outcome of early continuous positive airway pressure (CPAP) in preterm newborns with respiratory distress syndrome","volume":"121","author":"Das M","year":"2023","unstructured":"Das M, Dasgupta MK. Outcome of early continuous positive airway pressure (CPAP) in preterm newborns with respiratory distress syndrome. J Indian Med Assoc 2023; 121(5): 28\u201331.","journal-title":"J Indian Med Assoc"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000528914"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-018-0049-3"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000499674"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25678"},{"issue":"12","key":"e_1_3_5_17_2","first-page":"1691","article-title":"Cause-specific neonatal mortality in India: systematic review and meta-analysis","volume":"39","author":"Jain K","year":"2019","unstructured":"Jain K, Nangia S, Ballambattu VB, et al. Cause-specific neonatal mortality in India: systematic review and meta-analysis. J Perinatol 2019; 39(12): 1691\u20131700.","journal-title":"J Perinatol"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0086327"},{"key":"e_1_3_5_19_2","first-page":"264","article-title":"Neonatal respiratory distress in a reference neonatal unit in Cameroon: an analysis of prevalence, predictors of survival and case-fatality rates","volume":"38","author":"Tochie JN","year":"2021","unstructured":"Tochie JN, Choukem SP, Langmia RN, et al. Neonatal respiratory distress in a reference neonatal unit in Cameroon: an analysis of prevalence, predictors of survival and case-fatality rates. Pan Afr Med J 2021; 38: 264.","journal-title":"Pan Afr Med J"},{"issue":"2","key":"e_1_3_5_20_2","first-page":"257","article-title":"Bubble continuous positive airway pressure management and outcomes in preterm and term infants in a low-middle income country","volume":"111","author":"Ekhaguere OA","year":"2022","unstructured":"Ekhaguere OA, Patel S, Bhutani VK. Bubble continuous positive airway pressure management and outcomes in preterm and term infants in a low-middle income country. Acta Paediatr 2022; 111(2): 257\u2013264.","journal-title":"Acta Paediatr"},{"key":"e_1_3_5_21_2","first-page":"e2021053661","article-title":"Noninvasive respiratory support for preterm infants in low- and middle-income countries","volume":"149","author":"Bhutani VK","year":"2022","unstructured":"Bhutani VK, Ekhaguere OA, Bhutani S. Noninvasive respiratory support for preterm infants in low- and middle-income countries. Pediatrics 2022; 149(Suppl 1): e2021053661.","journal-title":"Pediatrics"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-04038-6"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261443957","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19345798261443957","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261443957","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:20:32Z","timestamp":1792149632000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19345798261443957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/19345798261443957"],"URL":"https:\/\/doi.org\/10.1177\/19345798261443957","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}