Background:      At present, perinatal mortality rate is one of the major public health problem of Thailand. This could contribute to the high overall mortality rate. Many studies revealed  that main cause of perinatal mortality was respiratory distress syndrome( RDS ) in preterm infants. Identification of risk factors for death among newborns with RDS might be  helpful in developing strategies to prevent this type of death.

 Objective:   To determine risk factors for death among newborns with respiratory distress syndrome at Kalasin hospital.

Study design:  Case – control  study.

Setting:        NICU, department of Pediatrics, Kalasin hospital.

Subject:       148 newborns with respiratory distress syndrome  who were hospitalized in Kalasin hospital from january 2002 to december 2004.

Method:     Data on socio-economic factors, antepartum factors, intrapartum and fetal factors were compared between newborns who died(cases) and survived(controls) by  univariate and multiple logistic regression analysis, odds ratio and 95% confidence interval were applied to evaluate there risk factors.        

Results:        Risk factors for death in newborns with the respiratory distress syndrome     included less than  30 weeks of gestational age (OR  12.10, 95% CI  3.04 - 48.20),   breech presentation (OR 5.17, 95% CI  1.02 – 13.17) and less than or equal to 7 in 5   minute APGAR score (OR    4.05, 95% CI  1.27 – 23.51).  

Conclusion:  Risk factors for death in newborns with respiratory distress syndrome   include  gestational age < 30 weeks, breech presentation and APGAR score at 5     minute less than or equal to 7. 

  Key word:  Respiratory distress syndrome, Risk factor, death, Kalasin hospital.