Risk factors that can lead to development of meconium aspiration syndrome

Abstract

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.

Meconium aspiration syndrome: incidence, associated risk factors and outcome‐evidence from a multicentric study in low‐resource settings in Nepal

“…Babies born to nulliparous mothers had a risk of developing MAS in this study. This finding is consistent with a prior study which also showed that babies born to nulliparous mothers were at higher risk of developing MAS . Being a nulliparous woman increases the risk of operative delivery due to various adverse intrapartum events.…”

“…Another significant mode of delivery associated with MAS was caesarean delivery. This finding is consistent with a prior study reporting 60% of babies who developed MAS were born through caesarean section . Another study also suggests that caesarean delivery poses a higher risk for MAS since meconium stained amniotic fluid leading to fetal distress could be an indication for caesarean delivery …”

“…Numerous studies have been carried out to identify possible risk factors associated with MAS. Risk factors such as ethnicity, longer gestational age (≥ 42 weeks), caesarean delivery, premature rupture of membranes and nulliparity have been identified …”

Prognostic Value of Serum Lactate Level in Umbilical Cord in Predicting Complications and Outcome of Meconium Aspiration Syndrome

“…We disagree with Rovas et al, [13] examined the risk variables that produce meconium attraction; they showed that the development of meconium attraction was not related to the development of maternal hypertension.…”

Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

“…20,21 It occurs in 8-47.6% of neonates in African countries and is the leading cause of NICU admission. [22][23][24][25][26][27] Gestational age, birth weight, and CS delivery are risk factors for respiratory distress, 28 whereas induced labor, prolonged labor, and cesarean birth are the risk factors for MAS. 29 Recently, CS delivery is increasing globally, with the justification of reducing maternal and neonatal morbidity and mortality.…”