Meconium Aspiration Syndrome – a 21-years’ Experience from a Tertiary Care Center and Analysis of Risk Factors for Predicting Disease Severity

Abstract

Aim of this study was to describe the course of perinatal factors in neonates with meconium aspiration syndrome (MAS) from 1990 to 2010 and to determine risk factors for a severe course of the disease.All neonates with MAS hospitalized in our level III neonatal intensive care unit from 1990 to 2010.Retrospective analysis of trends of perinatal factors in neonates with MAS over time and of the association of these factors with severe MAS (need for invasive mechanical ventilation for ≥7 days, or need for high frequency oscillation or need for extracorporeal membrane oxygenation).We included 205 neonates with MAS, 55 had severe MAS (27%). MAS incidence and absolute number of MAS cases per year decreased during the observation period (p=0.003 and 0.005, respectively) as well as rates of outborn deliveries (p=0.004), duration of invasive mechanical ventilation (p=0.004), and hospital stay (p=0.036). Incidence and absolute number of severe MAS cases per year decreased (p=0.008 and 0.006, respectively), though the percentage of severe MAS among all neonates with MAS did not change. Risk factors for severe MAS were acute tocolysis (odds ratio 18.2 (95% confidence interval 2.1-155.3), p<0.001) fetal distress (3.4 (1.8-6.4), p<0.001), and severe and moderate birth asphyxia (4.4 (2.0-9.7), p=0.001 and 2.9 (1.5-5.6), p=0.009).The incidence and absolute numbers of MAS and severe MAS cases changed during the study period as well as neonatal management. Acute tocolysis, fetal distress, and asphyxia were associated with severe MAS.

Meconium aspiration syndrome and neonatal outcome: a hospital based study

“…Similarly, in other studies by respiratory distress developed immediately after birth. 13,[25][26][27] Total 15 neonates (19%) of MAS babies required assisted ventilation which was found to be similar in other studies. 1,24,[28][29][30][31] Out of the 15 neonates requiring assisted ventilation, babies on Mechanical ventilation were 6 and 9 neonates were put on Nasal CPAP.…”

Barriers to enrollment in a randomized controlled trial of hydrocortisone for cardiovascular insufficiency in term and late preterm newborn infants

“…Based on the observational study, we anticipated an eligible population of >125/year, even after allowing for the specified exclusions. The decreased number of eligible infants we encountered between 2009 and 2015 is consistent with clinical perceptions and with other studies documenting that fewer term and late preterm infants are being intubated and mechanically ventilated in recent years 14 – 17 .…”

Scientific Evidence about the Assistance Provided to the Newborn with Meconium Elimination: Integrative Literature Review

“…Among neonatal variables, intrauterine growth restriction (IUGR), cardiac congenital anomalies, male, the lowest Apgar score [11] [16] stand out. Neonatal asphyxia, acute tocolysis, fetal distress and complicated delivery are still among the main risk factors for the development of MAS [17].…”

“…Thus, the incidence of MAS varies from population to population and from one country to another [18] [19]. And the apparent reduction in the incidence of this pathology in some countries is due to a greater knowledge of risk factors and advances in obstetric practices [17].…”