Incidence and risk factors of meconium aspiration syndrome at Hatyai Hospital

Abstract

Background: Meconium aspiration syndrome (MAS) is a cause of neonatal mortality rate. The surveillance for risk factors can prevent the incidence of disease. The objective of this study is to determine the incidence and risk factors of MAS and look at prognostic factors. Materials and Methods: A retrospective cohort study was conducted. The medical records of neonates with meconium-stained amniotic fluid (MSAF) were reviewed consecutively at Hatyai Hospital during January 2001 to July 2002. The diagnostic criteria of MAS included neonates with thick MSAF, respiratory distress and abnormal chest x-rays within 48 hours after birth. Univariate and multivariate analyses were performed for risk factors. Results: A total of 290 MSAF neonates were enrolled. The incidence of MAS was 16.5% of MSAF. Six cases of MAS died (12.5%). Fifty four percent of MAS needed mechanical ventilation. The complications of MAS were persistent pulmonary hypertension in newborn (PPHN, 20.8%), pneumothorax (16.7%), and probable sepsis (10.4%). The risk factors of MAS were premature rupture of membranes (PROM) > 18 hours (OR=44.25, 95% CI 6.08, 321.85), post term (OR=5.62, 95% CI 1.11, 28.46) , abnormal non-stress test (OR=6.58, 95% CI 1.70,25.46), late deceleration contraction stress test (OR=5.88, 95% CI 1.04, 33.16) and variable deceleration contraction stress test (OR=10.25, 95% CI 1.42, 73.83). The poor prognostic factor of MAS was PPHN (OR=24.33, 95% CI 1.86, 318.84) Conclusion: The incidence of MAS was 16.5% of MSAF. The risk factors of MAS were post term, PROM > 18 hours, and non-reassuring fetal heart rate. The poor prognostic factor of MAS was PPHN.

Keywords

• meconium-stained amniotic fluid (msaf)
• meconium aspiration syndrome (mas)