The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2017
Meconium aspiration syndrome: risk factors and predictors of severity.
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Oliveira Cláudia Patrícia Lourenço, Flôr-de-Lima Filipa, Rocha Gustavo Marcondes Duarte, Machado Ana Paula, Guimarães Pereira Areias Maria Hercília Ferreira
Аннотация
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.
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.
Предметные рубрики MeSH
AdultApgar ScoreC-Reactive ProteinCase-Control StudiesCesarean SectionFemaleHeart Rate, FetalHumansInfant, NewbornIntensive Care Units, NeonatalIntubation, IntratrachealMaleMeconium Aspiration SyndromeObstetric Labor ComplicationsPregnancyRetrospective StudiesRisk FactorsSeverity of Illness IndexStatistics, NonparametricYoung Adult