title: Meconium aspiration syndrome--a 21-years' experience from a tertiary care center and analysis of risk factors for predicting disease severity.
abstract: Aim of this study was to describe the course of perinatal factors in neonates with meconium aspiration syndrome (MAS) from 1990 to 2010 and to determine risk factors for a severe course of the disease.All neonates with MAS hospitalized in our level III neonatal intensive care unit from 1990 to 2010.Retrospective analysis of trends of perinatal factors in neonates with MAS over time and of the association of these factors with severe MAS (need for invasive mechanical ventilation for ≥7 days, or need for high frequency oscillation or need for extracorporeal membrane oxygenation).We included 205 neonates with MAS, 55 had severe MAS (27%). MAS incidence and absolute number of MAS cases per year decreased during the observation period (p=0.003 and 0.005, respectively) as well as rates of outborn deliveries (p=0.004), duration of invasive mechanical ventilation (p=0.004), and hospital stay (p=0.036). Incidence and absolute number of severe MAS cases per year decreased (p=0.008 and 0.006, respectively), though the percentage of severe MAS among all neonates with MAS did not change. Risk factors for severe MAS were acute tocolysis (odds ratio 18.2 (95% confidence interval 2.1-155.3), p<0.001) fetal distress (3.4 (1.8-6.4), p<0.001), and severe and moderate birth asphyxia (4.4 (2.0-9.7), p=0.001 and 2.9 (1.5-5.6), p=0.009).The incidence and absolute numbers of MAS and severe MAS cases changed during the study period as well as neonatal management. Acute tocolysis, fetal distress, and asphyxia were associated with severe MAS.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: N
authors.initials: N
authors.lastname: Hofer
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Jank
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Resch
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Urlesberger
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Reiterer
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Resch
mesh_terms: D001238:Asphyxia Neonatorum / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001317:Austria; D015148:Cardiotocography; D002423:Cause of Death / Q000639:trends; D003430:Cross-Sectional Studies; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015145:Tocolysis