Analysis of clinical outcomes and related factors of meconium aspiration syndrome in neonates

ObjectiveTo analyze the clinical outcomes and related factors of meconium aspiration syndrome (MAS) in neonates.

MethodsThe clinical data of 80 neonates with MAS were retrospectively analyzed.According to the prognosis, they were divided into mild group and severe group.The clinical data were compared between the two groups, the risk factors that affected the poor prognosis of MAS were analyzed by multivariate logistic regression, and the incidence of complications and risk factors of major complications in MAS neonates were analyzed.

ResultsAmong the 80 neonates, 14 gave up treatment or died, with a poor prognosis rate of 17.50%.The proportion of fetal age>40 weeks, asphyxia history, amniotic fluid Ⅲ ° pollution, placental abnormalities, Apgar score≤7 points at 5 min of birth, cesarean section, chest X-ray grading in the severe group was higher than those in the mild group (P < 0.05 to P < 0.01), and the proportion of Apgar score at 1 min of birth, meconium aspiration through respiratory tract immediately after birth, mechanical ventilation, probiotics supplementation in the severe group was lower than those in the mild group (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that gestational age>40 weeks, asphyxia history, amniotic fluid Ⅲ ° pollution, Apgar score < 7 points at 5 min of birth were the risk factors for poor prognosis in MAS neonates (P < 0.05 to P < 0.01), and immediately clearing meconium through respiratory tract after birth, mechanical ventilation, probiotics supplementation were the protective factors (P < 0.05 to P < 0.01).The main complications of MAS neonates were hypoxic-ischemic encephalopathy (43/80, 53.75%), respiratory failure (38/80, 48.75%), pulmonary arterial hypertension (32/80, 40.00%) and metabolic acidosis (28/80, 35.00%).Univariate and multivariate logistic regression analysis showed that gestational age>40 weeks, elderly age of pregnant women, amniotic fluid Ⅲ ° pollution, and history of fetal asphyxia were the main risk factors for MAS neonates complicated with hypoxic-ischemic encephalopathy (P < 0.05 to P < 0.01), while immediately clearing meconium through respiratory tract after birth was the protective factor (P < 0.05).

ConclusionsMAS neonates may abandon treatment or die in hospital due to the influence of gestational age, amniotic fluid pollution, asphyxia history, Apgar score and so on.Immediately clearing meconium through respiratory tract after birth, assisted mechanical ventilation and probiotic supplementation can help to improve clinical outcomes and reduce the risk of complications.