Chest · 2026
Meconium Aspiration Syndrome and the Association With Preschool Asthma.
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Gatt Dvir, Ben-Shitrit Itamar, Golan-Tripto Inbal, Goldbart Aviv, Hazan Guy
Аннотация
BACKGROUND: Meconium aspiration syndrome (MAS) is an acute neonatal respiratory disorder resulting from aspiration of meconium-stained amniotic fluid, leading to airway obstruction, inflammation, and hypoxemia. Although its perinatal presentation is well described, its long-term association with asthma remains unknown.
RESEARCH QUESTION: Is MAS associated with subsequent development of preschool asthma?
STUDY DESIGN AND METHODS: A retrospective cohort study was conducted using a national database, which included infants born between 2010 and 2024 with continuous follow-up until 6 years of age. Each child with MAS was matched 1:4 with control participants without MAS using Mahalanobis distance matching. The primary outcome was asthma, defined by the Asthma Integrated Diagnosis Index, a specific composite measure. Secondary outcomes included individual asthma-related diagnoses and medication use. Kaplan-Meier analysis was performed to evaluate time to outcome, accounting for the age at which events occurred.
RESULTS: Among 326,940 eligible children, 730 children (0.2%) had a diagnosis of MAS. After matching, MAS was associated with 64% higher proportion of asthma up to 6 years of age (95% CI, 1.29-2.06; P < .001). Other long-term respiratory morbidities, such as bronchiolitis and OSA, also were more frequent among survivors of MAS. Atopic conditions, including dermatitis, rhinitis, and food allergies, did not differ significantly between groups. Sensitivity analysis using inverse probability of treatment weighting supported these findings.
INTERPRETATION: Our results show that MAS is associated with increased risks of asthma and bronchiolitis in early childhood. These findings suggest that neonatal lung injury resulting from MAS may impair airway development, contributing to asthma inception.
RESEARCH QUESTION: Is MAS associated with subsequent development of preschool asthma?
STUDY DESIGN AND METHODS: A retrospective cohort study was conducted using a national database, which included infants born between 2010 and 2024 with continuous follow-up until 6 years of age. Each child with MAS was matched 1:4 with control participants without MAS using Mahalanobis distance matching. The primary outcome was asthma, defined by the Asthma Integrated Diagnosis Index, a specific composite measure. Secondary outcomes included individual asthma-related diagnoses and medication use. Kaplan-Meier analysis was performed to evaluate time to outcome, accounting for the age at which events occurred.
RESULTS: Among 326,940 eligible children, 730 children (0.2%) had a diagnosis of MAS. After matching, MAS was associated with 64% higher proportion of asthma up to 6 years of age (95% CI, 1.29-2.06; P < .001). Other long-term respiratory morbidities, such as bronchiolitis and OSA, also were more frequent among survivors of MAS. Atopic conditions, including dermatitis, rhinitis, and food allergies, did not differ significantly between groups. Sensitivity analysis using inverse probability of treatment weighting supported these findings.
INTERPRETATION: Our results show that MAS is associated with increased risks of asthma and bronchiolitis in early childhood. These findings suggest that neonatal lung injury resulting from MAS may impair airway development, contributing to asthma inception.