Clinical Profile and Outcome of Neonates with Meconium Aspiration Syndrome at an Indian Tertiary Care: An Observational Study

Background Meconium aspiration syndrome (MAS) is still a major contributor to newborn respiratory morbidity and mortality. Many centres lack advanced modalities such as high-frequency oscillatory ventilation and inhaled nitric oxide. Very few studies in developing countries have focused on its clinical profile, management, respiratory morbidity and mortality. Objectives The aim of this study was to determine the incidence, risk factors, complications and outcomes in neonates with MAS. Methods A retrospective observational study was conducted in a level III neonatal intensive care unit of an outborn tertiary referral centre in South India. Case sheets of neonates, born out of meconium-stained liquor who had respiratory distress at admission and were diagnosed as MAS, were included. The primary outcome was to study the clinical profile of neonates with MAS. The secondary outcomes were to estimate the proportion of neonates who developed complications of MAS. Results The incidence of MAS over a 5-year period, out of total 8,990 neonates admitted at our centre, was 161 (1.79 %). Data of 161 neonates were analysed. The neonates were admitted at a median duration of 5 h of life (interquartile range 3–14). Mean gestational age and weight were 38.7 (1.41) weeks and 2900 (530) g, respectively. Associated morbidities like shock were seen in 55 (34.1%), persistent pulmonary hypertension of newborns in 40 (24.8 %), hypoxic ischemic encephalopathy in 23 (14.2%), seizures in 16 (9.9%), pneumothorax in 8 (4.96%) and sepsis in 34 (21.1%). On logistic regression analysis, age at admission >24 h, small for gestational age (SGA) and need for resuscitation at birth were risk factors associated with severe MAS. Mortality in MAS was 7 (4.34%). Conclusion Need for resuscitation, SGA at birth and age at admission >24 h were associated with severe MAS. Timely referral of neonates with a risk factor for severe MAS can improve outcomes.