Amitai Komem Daphna, Meyer Raanan, Yinon Yoav, Levin Gabriel
The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.
The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Int J Gynaecol Obstet. 2022 Sep;158(3):551-556. doi: 10.1002/ijgo.14034. Epub 2021 Dec 9.
To identify risk factors associated with the occurrence of meconium aspiration syndrome (MAS) among neonates.
A retrospective case-control study in a university affiliated tertiary medical center, including all neonates born with meconium stained amniotic fluid (MSAF) between March 2011 and March 2020. Patients were categorized by the occurrence of MAS. Demographic, pregnancy and delivery characteristics were compared between the two groups. Risk factors for MAS were analyzed.
Of 90 579 singleton deliveries, a total of 11 856 with MSAF were included. Of these newborns, 78 (0.66%) were diagnosed with MAS Four factors were independently associated with MAS: delivery at <38 0/7 weeks (aOR [95% CI]: 3.48 (1.02-11.84), P = 0.046); higher body mass index (aOR [95% CI]: 1.09 (1.02-1.16), P = 0.003); lower amniotic fluid index (aOR [95% CI]: 0.99 (0.98-0.99), P = 0.032); higher white blood cell count (aOR [95% CI]: 1.11 (1.02-1.20), P = 0.009). The presence of one, two and three of the above-mentioned risk factors yielded a risk for MAS of 0.8%, 2.5% and 100%, respectively.
We identified independent risk factors for MAS and developed a risk score calculator. This tool may assist physicians in the management of deliveries complicated by MSAF.
确定新生儿胎粪吸入综合征（MAS）发生的相关危险因素。
在一所大学附属三级医疗中心进行一项回顾性病例对照研究，纳入2011年3月至2020年3月期间所有出生时羊水胎粪污染（MSAF）的新生儿。根据MAS的发生情况对患者进行分类。比较两组的人口统计学、妊娠和分娩特征。分析MAS的危险因素。
在90579例单胎分娩中，共有11856例有MSAF。在这些新生儿中，78例（0.66%）被诊断为MAS。四个因素与MAS独立相关：孕<38 0/7周分娩（调整后比值比[aOR][95%置信区间]：3.48[1.02 - 11.84]，P = 0.046）；较高的体重指数（aOR[95%置信区间]：1.09[1.02 - 1.16]，P = 0.003）；较低的羊水指数（aOR[95%置信区间]：0.99[0.98 - 0.99]，P = 0.032）；较高的白细胞计数（aOR[95%置信区间]：1.11[1.02 - 1.20]，P = 0.009）。上述危险因素存在1个、2个和3个时，MAS发生风险分别为0.8%、2.5%和100%。
我们确定了MAS的独立危险因素并开发了风险评分计算器。该工具可能有助于医生管理伴有MSAF的分娩。
