Meydanli M M, Dilbaz B, Calişkan E, Dilbaz S, Haberal A
SSK Maternity and Women's Health Teaching Hospital, Ankara, Turkey.
Int J Gynaecol Obstet. 2001 Jan;72(1):9-15. doi: 10.1016/s0020-7292(00)00265-4.
To determine risk factors for meconium aspiration syndrome (MAS).
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).
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.
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.
确定胎粪吸入综合征（MAS）的危险因素。
对70例连续的单胎妊娠进行队列研究，这些妊娠合并浓稠胎粪污染羊水且孕龄≥37周。将病例随机分为选择性剖宫产或在进行20分钟的外部胎儿心率（FHR）监测后自然阴道分娩。通过计算相对风险（RR）和比值比（OR）对MAS进行风险估计分析。
声带以下存在胎粪（RR = 7.3，95%可信区间[CI] = 2.6 - 20.3）、FHR监护结果不良（RR = 3.0，95%CI = 1.2 - 7.5）、5分钟时阿氏评分≤6分（RR = 3.8，95%CI = 1.7 - 8.4）以及脐血血浆促红细胞生成素（UCPer）水平＞50 mIU/ml（RR = 5.0，95%CI = 2.1 - 12.0）被发现是MAS的显著危险因素。在多变量分析结束时，声带以下存在胎粪（OR = 33.4，95%CI = 3.6 - 303.7）和FHR监护结果不良（OR = 12.2，95%CI = 1.3 - 111.7）仍然是显著的危险因素。
FHR监护结果不良以及声带以下存在胎粪与通过浓稠胎粪出生的婴儿发生MAS的风险增加相关。
