Risk factors of mortality in meconium aspiration syndrome: review of 314 cases.

Meconium aspiration syndrome (MAS) is a common severe respiratory disease in full-term infants. To investigate the risk factors for mortality of MAS, a retrospective chart-review study of MAS was conducted from 1995 to 2001. All cases of MAS were included except cases of cyanotic congenital heart disease or congenital fetal anomaly. Prenatal, perinatal and postnatal risk factors of mortality were recorded. The risk factors were compared between surviving and deceased cases. There were 314 cases of MAS during the seven years. Total mortality rate was 4.8% (15/314); this did not change significantly during these years. Risk factors of mortality by univariate analysis were: outborn babies, resuscitation before admission, first born baby, low pH, high oxygen index (OI), high alveolar-arterial oxygen tension gradient (AaDO2) at admission, high OI and AaDO2 at 2 hours after admission, shock, pneumothorax, asphyxia, pulmonary hemorrhage, persistent pulmonary hypertension of newborn (PPHN), and renal failure. Logistic regression analysis showed asphyxia, pneumothorax and PPHN are the most important risk factors of mortality in MAS. How to diminish these events is the key point for reducing the mortality rate of MAS.