Background: Respiratory distress (RD) is a common syndrome in the neonatal period, especially occurring in the first few days after birth. Nasal continuous positive airway pressure (NCPAP) is a method of supporting infants with RD who are still able to breathe spontaneously by maintaining a continuous positive pressure throughout the breathing cycle.

Aims: This study aims to evaluate the final outcomes and risk factors affecting the outcomes of NCPAP for neonate with respiratory distress.

Patients and Methods: The study design was a prospective descriptive study. Neonates under 28 days of age with RD requiring NCPAP ventilation were included in the study. NCPAP outcomes were evaluated at 1 hour, 6 hours, 12 hours, 24 hours, and 48 hours after NCPAP ventilation.

Results: The study was conducted on 105 neonates with RD treated with NCPAP at Bac Ninh Obstetrics and Pediatrics Hospital from January to June 2025. Of these, 62 (59%) were boys. There were 44 (41.9%) neonates had a gestational age from 32 to 37 weeks, 32 (30.5%) from 28 to 32 weeks and 10(9.5%) under 28 weeks. Neonates with birth weight 1500-2500g were 46(43.8%) and there were only 4(3.8%) neonates with birth weight under 1000g. Vaginal delivery was more common than cesarean section, with rate of 59% and 41% respectively. Most children had moderate respiratory distress, accounting for 74.3%. The general success rate of NCPAP were 72.5%, while the remaining 27.6% neonates failed with NCPAP had to be switched to invasive mechanical ventilation. The failure rate of NCPAP for premature born before 32 weeks was 54.5%, higher than for premature born at 32 weeks or more (8.2%) (OR = 12.5; 95% CI=4.2-37.1; p<0.001). Neonates with birth weight < 1500g had a NCPAP failure rate of 48.8%, higher than neonates with birth weight ≥ 1500g (11.3%) with OR=7.2; 95%CI=2.4-21.6; p<0.001. Neonates with Apgar score < 7 had a NCPAP failure rate of 56.0%, higher than neonates with Apgar score ≥ 7 (16.3%) with OR = 6.2; 95%CI=2.0-19.3; p<0.001. Neonates with severe RD (Silverman score > 5) had a NCPAP failure rate of 54.1%, higher than infants with Silverman scores 3-5 (9.9%) with OR=10.1; 95%CI= 3.4 – 30.0; p<0.001. Neonates delivered by cesarean section had a NCPAP failure rate of 60.0%, higher than vaginal delivery neonates (15.3%) with OR=3.8; 95%CI=1.5-9.7; p<0.001.

Conclusion: The general success rate of NCPAP in neonates with RD after 48 hours were 72.5%. Neonates who failed NCPAP (27.6%) had to be switched to invasive mechanical ventilation. Risk factors that increase the failure rate of NCPAP are gestational age under 32 weeks, birth weight < 1500g, Apgar score < 7 after birth, severe RD with Silverman score > 5 and cesarean section.