Meconium aspiration syndrome: risk factors and predictors of severity

J Matern Fetal Neonatal Med. 2019 May;32(9):1492-1498. doi: 10.1080/14767058.2017.1410700. Epub 2017 Dec 8.

Abstract

Purpose: To identify risk factors and predictors of severity associated with meconium aspiration syndrome (MAS) in the patients admitted to the neonatal intensive care unit (NICU).

Materials and methods: Retrospective study including newborns admitted, between 2005 and 2015, with a diagnosis of MAS.

Results: Of the newborns admitted to the NICU, 0.66% were diagnosed with MAS. These had higher prevalence of caesarean delivery (p < .001), nonreassuring or abnormal cardiotocography (CTG) (p < .001), intrapartum maternal fever (p = .002), Apgar scores at the first minute <7 (p < .001) and need of endotracheal intubation at birth (p < .001). Newborns with severe MAS had higher median reactive C protein (86.9 versus 9.65, p = .001) and 73.3% had pulmonary hypertension (p = .027). They required significantly more days of oxygen therapy, mechanical ventilation, nitric oxide, inotropic, and surfactant therapy, as well as longer hospital stay.

Conclusions: Nonreassuring or abnormal CTG and low Apgar score at the first minute were established as risk factors for MAS and need of surfactant therapy as a predictor of severity.

Keywords: Meconium aspiration syndrome; neonatal intensive care unit; perinatal asphyxia; predictors of severity; risk factors.

MeSH terms

  • Adult
  • Apgar Score*
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Cesarean Section / statistics & numerical data
  • Female
  • Heart Rate, Fetal*
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Intubation, Intratracheal / statistics & numerical data
  • Male
  • Meconium Aspiration Syndrome / classification
  • Meconium Aspiration Syndrome / epidemiology*
  • Obstetric Labor Complications / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Statistics, Nonparametric
  • Young Adult

Substances

  • C-Reactive Protein