Obstet Gynecol Sci.  2015 Jan;58(1):24-31. 10.5468/ogs.2015.58.1.24.

Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates

• Choi W
• Jeong H
• Choi SJ
• Oh SY
• Kim JS
• Roh CR
• Kim JH

• KMID: 1994223
• DOI: http://doi.org/10.5468/ogs.2015.58.1.24

Abstract

OBJECTIVE
The aim of this study was to compare the risk factors associated with mild/moderate meconium aspiration syndrome (MAS) with those associated with severe in meconium-stained term neonates.
METHODS
Consecutive singleton term neonates (n=671) with meconium staining at birth from all deliveries (n=14,666) in our institution from January 2006 to December 2012 were included. Both maternal and neonatal variables were examined. Among the study population, for women who underwent the trial of labor (n=644), variables associated with labor were also examined. These variables were compared between the mild/moderate MAS group, the severe MAS group, and the MAS-absent group.
RESULTS
MAS developed in 10.6% (71/671) of neonates with meconium staining at birth. Among the neonates with MAS, 81.7% had mild MAS, 5.6% had moderate MAS, and 12.7% had severe MAS. The presence of minimal variability was significantly increased in both the mild/moderate and the severe MAS groups. The frequencies of nulliparity, fetal tachycardia, and intrapartum fever were significantly increased in the mild/moderate MAS group, but not in the severe MAS group. While a longer duration of the second stage of labor was significantly associated with mild/moderate MAS, severe MAS was associated with a shorter duration of the second stage. Notably, low mean cord pH (7.165 [6.850-7.375]) was significantly associated with mild/moderate MAS, but not with severe MAS (7.220 [7.021-7.407]) compared with the absence of MAS (7.268 [7.265-7.271]).
CONCLUSION
Our data suggest the development of severe MAS is not simply a linear extension of the same risk factors driving mild/moderate MAS.

Keyword

Meconium aspiration syndrome; Risk factors

MeSH Terms

Female
Fever
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Infant, Newborn*
Meconium
Meconium Aspiration Syndrome*
Parity
Parturition
Risk Factors*
Tachycardia
Trial of Labor

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