Objective: To determine the frequency of Meconium Aspiration Syndrome (MAS) in neonates born through Meconium Stained Amniotic Fluid (MSAF) and to identify the risk factors that can lead to the development of MAS.
Method:The study includes all neonates born in 2014 through MSAF. Risk factors associated with pregnancy, delivery and the neonates' condition were identified. Results between groups -the Meconium Aspiration Syndrome (MAS) group, the meconium in the lower vocal cords, but no Meconium Aspiration Syndrome (MLVC) group, and the MSAF group -were compared.Results: Out of the 2040 births in 2014, 307 neonates were born through meconium stained amniotic fluid. MAS were confirmed in 17 neonates (5.5%). Statistically significant differences between the MAS and the MSAF groups were found in the following: parity (MAS was more likely in nulliparous women (p-0.024, RR-1.8, 95% CI 1.4-2.3; p-0.045), the BMI of women (28.2±4.1 in the MSAF group and 30.6±4.2 in the MAS group (T-2.24; p-0.027)), and respiratory tract infections and anaemia during pregnancy, which were more common in the MAS group (p-0.02 ; p-0.035). MAS was more likely to occur upon induction of labour, meconium was thick, and the duration of labour was longer in first and second stages (p-0.003, p-0.0022, p-0.022, p-0.000). 60% of neonates who developed MAS were born through cesarean-section, compared to 31% born through cesarean-section in the MSAF group (p-0.043). Pathological changes in CTG were more common in the MAS group (47% compared to 4% in the MSAF group, p-0.035). The likelihood of MAS in neonates was found to increase with lower Apgar scores at minute 1 and minute 5; lower cord blood pH was also a risk factor for MAS (p-0.000, p-0.000, p-0.009).
Conclusions:Prolonged labour, lower Apgar scores, induction of labour, thick meconium, nulliparity, respiratory tract infections and anaemia during pregnancy were associated with MAS. Factors such as urinary tract infections, hypertensive disorders, neonate birth weight and sex were not found to be statistically significant in this study.