Incidence and outcomes of newborn admitted with severe meconium aspiration syndrome over a 17-year period in a tertiary care centre in India

Résumé fourni par la source

Meconium aspiration syndrome (MAS) is one of the common causes of respiratory distress among newborn. Severe MAS is associated with considerable morbidity and mortality, and there is sparse data on this entity from large studies from low- and middle-income countries. To determine the incidence of meconium aspiration syndrome (MAS) and severe MAS in a large perinatal centre over a 17-year period and to study the clinical course, complications, and outcomes of newborn with severe MAS. This was a retrospective study of babies admitted in the unit between 2006 and 2022. The list of babies with a diagnosis of MAS was extracted from the admission register and cross-checked with the ventilation database and discharge summaries. Relevant maternal, perinatal as well as postnatal courses, investigations, and outcomes were collected from the clinical workstation and the summaries. During the 17-year period, there were 206 377 deliveries in the hospital. There were 1294 babies admitted with MAS; 146 (11.3%) babies satisfied the criteria for severe MAS. With 73 of these newborn being inborn, incidence of severe MAS was 3.5/10 000 (95% CI 2.7-4.3/10 000) live births among inborn babies. High-frequency ventilation was required in 54 newborn (37%). The median duration of ventilation was 4 days (IQR 3-7 days). Sixteen babies had pulmonary air leak (11%) and persistent pulmonary hypertension (PPHN) was present in 63 babies (43%). The median length of hospital stay was 13 days (IQR 9-18). Of the 146 newborn with severe MAS, 118 survived (80.8%). Adverse outcome was associated with presence of PPHN [OR-5.24 (95% CI 1.7-15.9)] and pneumothorax [OR-17.3 (95% CI 3.5-85.2)]. Sixty-nine (53.9%) of the survivors had long-term follow-up. Adverse neurodevelopmental outcomes were present in 7.8% of neonates, which included developmental delay, microcephaly, cerebral palsy, seizure disorder, autistic traits, and hearing loss. A small proportion (11.3%) of babies with MAS had severe MAS. Nearly one-fifth of babies with severe MAS had adverse short-term outcome. The presence of PPHN and air leaks were significantly associated with adverse outcomes.

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