Risk factors for meconium aspiration syndrome in infants born through thick meconium.
OBJECTIVE
To determine risk factors for meconium aspiration syndrome (MAS).


METHODS
A cohort study was conducted of 70 consecutive singleton pregnancies complicated with thick meconium-stained amniotic fluid delivered at > or = 37 weeks' gestation. Cases were randomized either for elective abdominal delivery or spontaneous vaginal delivery after 20 min of external fetal heart rate (FHR) monitoring. Risk estimation analysis for MAS was performed calculating relative risks (RR) and odds ratios (OR).


RESULTS
The presence of meconium below the vocal cords (RR=7.3, 95% CI=2.6-20.3), non-reassuring FHR tracings (RR=3.0, 95% CI=1.2-7.5), Apgar score < or = 6 at 5 min (RR=3.8, 95% CI=1.7-8.4) and an umbilical cord plasma erythropoietin (UCPer) level > 50 mlU/ml (RR=5.0, 95% CI=2.1-12.0) were found to be significant risk factors for MAS. The presence of meconium below the vocal cords (OR=33.4, 95% CI=3.6-303.7) and non-reassuring FHR tracings (OR=12.2, 95% CI=1.3-111.7) remained as significant risk factors at the end of the multivariate analysis.


CONCLUSIONS
Non-reassuring FHR tracings and the presence of meconium below vocal cords are associated with an increased risk for MAS in infants born through thick meconium.
Meydanli
M M
MM
SSK Maternity and Women's Health Teaching Hospital, Ankara, Turkey.
Dilbaz
B
B
Calişkan
E
E
Dilbaz
S
S
Haberal
A
A
D000328:Adult; D000649:Amniocentesis; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D008470:Meconium / Q000737:chemistry*; D008471:Meconium Aspiration Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D013577:Syndrome