Severity, complications and outcome of meconium aspiration syndrome in neonates.

Objective: To determine the severity, complications, and outcomes of meconium aspiration syndrome (MAS) in neonates. Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit (NICU) of the National Institute of Child Health, Karachi, Pakistan. Period: January 2024 to June 2024. Methods: Neonates aged 1-28 days of either gender, and having MAS were analyzed. Vital signs were noted and necessary laboratory investigations were done. Presenting clinical features and associated complications of MAS were noted. Outcome was noted in the form of discharged, admitted to pediatric unit, or mortality. Results: In a total of 92 neonates, 66 (71.7%) were male. The mean age was 12.47±6.55 days. Evaluation of MAS severity revealed mild, moderate, and severe cases among 2 (2.2%), 16 (17.4%), and 74 (80.4%) neonates, respectively. The most frequently noted complications were sepsis 65 (70.7%), hyperinflated lungs 55 (59.8%), respiratory distress 34 (37.0%), and pulmonary hypertension 31 (33.7%), were the most commonly associated complications of MAS. Two neonates left against medical advice so those were excluded from the final outcome analysis. In the remaining 90 neonates, mortality was reported in 6 (6.7%). Mortality had significant association with bluish skin at presentation (p=0.044), severe MAS (p=0.001), and pulmonary hypertension (p=0.001). Conclusion: Vast majority of the neonates (80.4%) presented with severe MAS which should raise alarm about the time identification of these high risk neonates. The most frequently noted MAS associated complications were sepsis, hyperinflated lungs, respiratory distress, and pulmonary hypertension. At presentation, bluish skin, pulmonary hypertension, and severe MAS were significantly associated with mortality.