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The epidemiology of meconium aspiration syndrome (MAS) in term neonates is described in a population-based retrospective study of data recorded for all births from 2000 to 2007 in a French region (Burgundy). Of the 132 884 eligible term newborns, the rate of meconium-stained amniotic fluid (MSAF) was 7.93%. The prevalence of severe MAS was 0.067% in the overall population. MAS rate was 0.11% at 37-38 weeks of gestation (WG), 0.20% at 39–41 WG, and 0.49% at 42-43 WG. Factors independently associated with severe MAS were identified by a case-control study, that is, thick meconium amniotic fluid, fetal tachycardia, Apgar score ≤3 at 1 minute, and birth in a level III facility. Our results confirm the high prevalence of MSAF after 37 WG but also show the low frequency of severe MAS in a period corresponding to the new international recommendations on the management of birth with MSAF.

HCQ reduces neonatal morbidity in women with SLE by significantly decreasing the rate of prematurity and intrauterine growth restriction.

The acute renal effects of hypoxemia and the ability of theophylline to prevent these effects were assessed in anesthetized and mechanically-ventilated newborn and adult rabbits. Renal blood flow (RBF) and glomerular filtration rate (GFR) were determined by the clearance of para-aminohippuric acid and inulin, respectively. Each animal acted as his own control. In 14 newborn rabbits (group 1), hypoxemia was significantly associated with a fall in GFR (-22 +/- 6%) and filtration fraction (-17 +/- 3%) and with an increase in renal vascular resistance (+13 +/- 6%). Hypoxemia also induced a significant decline in GFR (-27 +/- 6%) and RBF (-29 +/- 6%) in 7 adult rabbits (group 3). Intravenous theophylline (0.5 mg/kg) completely prevented the hypoxemia-induced changes in GFR, filtration fraction (FF) and renal vascular resistance (RVR) in 8 newborn rabbits (group 2). An intravenous dose of 2.4 mg theophylline given after the induction of hypoxemia partially reversed the drop in GFR in adult rabbits (group 3). Separate renal functions were studied in 8 additional adult rabbits (group 4). Low-dose theophylline (27 micrograms/min) infused intra-arterially in the left kidney partially prevented the hypoxemia-induced decline in urine flow rate, GFR, RBF, FF as well as the increase in renal vascular resistance. The beneficial effects of theophylline could be mediated by its adenosine antagonistic properties.

Future studies should delineate more precisely the respective contribution of gestational age, maternal complication and induced delivery in the prognosis of infants born between 33 and 39 weeks gestation.

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