title: Risk factors for early and late onset of respiratory symptoms in babies born through meconium.
abstract: We sought (1) to identify risk factors for meconium aspiration syndrome (MAS) among infants born to women whose labors were complicated by thick-consistency meconium-stained amniotic fluid (MSAF), and (2) to determine whether risk factors and infant prognosis differ according to the time of onset of respiratory distress. We performed a secondary analysis of a multicenter randomized trial of amnioinfusion (AI) for the prevention of MAS among women with thick-consistency MSAF. MAS was defined as onset of respiratory distress requiring oxygen supplementation within the first 4 hours of life. Patients with respiratory symptoms with onset at >or=4 hours were treated as a separate outcome category, "late-onset respiratory distress." We developed peripartum and intrapartum regression models to identify the risk of MAS and its subgroups. A tracing with marked abnormalities was a significant risk factor for moderate/severe MAS, but not for mild MAS or for late-onset respiratory distress. Meconium below the vocal cords and need for resuscitation immediately after birth were risk factors for mild and moderate/severe MAS as well as for late-onset respiratory distress. The risk of nonrespiratory comorbidities varied directly according to the severity of the respiratory distress. Late-onset respiratory distress shares several risk factors with MAS, as defined by Rossi et al. The two conditions may represent different manifestations of the same disease process.
authors.affiliation: Department of Obstetrics and Gynecology, Université de Montréal/Hôpital Sainte-Justine, Montreal, Quebec, Canada.
authors.forename: Hairong
authors.initials: H
authors.lastname: Xu
authors.forename: Marie
authors.initials: M
authors.lastname: Calvet
authors.forename: Shuqin
authors.initials: S
authors.lastname: Wei
authors.forename: Zhong-Cheng
authors.initials: ZC
authors.lastname: Luo
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
mesh_terms: D000328:Adult; D017668:Age of Onset; D001238:Asphyxia Neonatorum / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D015992:Body Mass Index; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D016017:Odds Ratio; D011247:Pregnancy; D011336:Probability; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors