Effect of Endotracheal Suctioning on Infants Born through Meconium-Stained Amniotic Fluid: A Meta-analysis

Am J Perinatol. 2023 Sep;40(12):1272-1278. doi: 10.1055/s-0041-1741034. Epub 2022 Jan 11.

Abstract

Objective: Meconium is a common finding in amniotic fluid and placental specimens, particularly in term and post-term pregnancies. The objective of this paper was to perform a meta-analysis to examine the impact of endotracheal suctioning on the occurrence of meconium aspiration syndrome (MAS), mortality, and complications.

Study design: PubMed, EMBASE, and the Cochrane library were systematically searched for comparative studies. Odds ratios (ORs), weighted mean differences (WMDs), and corresponding 95% confidence intervals (CIs) were used to compare the outcomes.

Results: Twelve studies were included in the meta-analysis. There were no significant impacts of endotracheal suctioning on the occurrence of MAS (OR = 3.05, 95% CI: 0.48-19.56), mortality (OR = 1.25, 95% CI: 0.35-4.44), the need for mechanical ventilation (OR = 4.20, 95% CI: 0.32-54.72), the occurrence of pneumothorax (OR = 0.99, 95% CI: 0.34-2.85), persistent pulmonary hypertension of the newborn (PPHN), (OR = 1.31, 95% CI: 0.58-2.98), hypoxic-ischemic encephalopathy (HIE) (OR = 0.82, 95% CI: 0.52-1.30), and length of stay (WMD = -0.11, 95% CI: -0.99-0.77).

Conclusion: Routine endotracheal suctioning at birth is not useful in preventing MAS, mortality, mechanical ventilation, PPHN, HIE, and prolonged length of stay in neonates born through MSAF.

Key points: · Routine suctioning is not recommended for newborns.. · Endotracheal aspiration is not beneficial for MAS.. · Future research may focus on selected neonates..

Publication types

  • Meta-Analysis

MeSH terms

  • Amniotic Fluid
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Meconium
  • Meconium Aspiration Syndrome* / prevention & control
  • Parturition
  • Persistent Fetal Circulation Syndrome*
  • Placenta
  • Pregnancy