Choi Woneui, Jeong Heejeong, Choi Suk-Joo, Oh Soo-Young, Kim Jung-Sun, Roh Cheong-Rae, Kim Jong-Hwa
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2015 Jan;58(1):24-31. doi: 10.5468/ogs.2015.58.1.24. Epub 2015 Jan 16.
The aim of this study was to compare the risk factors associated with mild/moderate meconium aspiration syndrome (MAS) with those associated with severe in meconium-stained term neonates.
Consecutive singleton term neonates (n=671) with meconium staining at birth from all deliveries (n=14,666) in our institution from January 2006 to December 2012 were included. Both maternal and neonatal variables were examined. Among the study population, for women who underwent the trial of labor (n=644), variables associated with labor were also examined. These variables were compared between the mild/moderate MAS group, the severe MAS group, and the MAS-absent group.
MAS developed in 10.6% (71/671) of neonates with meconium staining at birth. Among the neonates with MAS, 81.7% had mild MAS, 5.6% had moderate MAS, and 12.7% had severe MAS. The presence of minimal variability was significantly increased in both the mild/moderate and the severe MAS groups. The frequencies of nulliparity, fetal tachycardia, and intrapartum fever were significantly increased in the mild/moderate MAS group, but not in the severe MAS group. While a longer duration of the second stage of labor was significantly associated with mild/moderate MAS, severe MAS was associated with a shorter duration of the second stage. Notably, low mean cord pH (7.165 [6.850-7.375]) was significantly associated with mild/moderate MAS, but not with severe MAS (7.220 [7.021-7.407]) compared with the absence of MAS (7.268 [7.265-7.271]).
Our data suggest the development of severe MAS is not simply a linear extension of the same risk factors driving mild/moderate MAS.
本研究旨在比较足月儿胎粪污染时，与轻度/中度胎粪吸入综合征（MAS）相关的危险因素和与重度MAS相关的危险因素。
纳入2006年1月至2012年12月在本机构所有分娩（n = 14,666）中出生时伴有胎粪污染的连续单胎足月儿（n = 671）。对母亲和新生儿的变量进行了检查。在研究人群中，对接受试产的女性（n = 644），还检查了与分娩相关的变量。在轻度/中度MAS组、重度MAS组和无MAS组之间比较这些变量。
出生时伴有胎粪污染的新生儿中，10.6%（71/671）发生了MAS。在患有MAS的新生儿中，81.7%为轻度MAS，5.6%为中度MAS，12.7%为重度MAS。轻度/中度和重度MAS组中最小变异的发生率均显著增加。轻度/中度MAS组中初产、胎儿心动过速和产时发热的发生率显著增加，但重度MAS组中未增加。虽然第二产程时间延长与轻度/中度MAS显著相关，但重度MAS与第二产程时间缩短相关。值得注意的是，与无MAS组（7.268 [7.265 - 7.271]）相比，平均脐带血pH值低（7.165 [6.850 - 7.375]）与轻度/中度MAS显著相关，但与重度MAS（7.220 [7.021 - 7.407]）无关。
我们的数据表明，重度MAS的发生并非简单地是导致轻度/中度MAS的相同危险因素的线性延伸。
