Department of Pediatrics, University of California at Davis, Sacramento, CA, USA.
Department of Pediatrics, Central Michigan University, Children's Hospital of Michigan, Detroit, MI, USA.
J Perinatol. 2022 Jun;42(6):769-774. doi: 10.1038/s41372-021-01287-0. Epub 2022 Jan 8.
To evaluate the short-term outcomes of non-vigorous infants born through meconium-stained amniotic fluid (MSAF) before and after implementation of no-tracheal suctioning guidelines.
Single-center retrospective study of ≥36-week gestation neonates with MSAF.
During routine-suction era (9/2013-12/2014), 280/2306 neonates (12%) were born through MSAF and 39 (14%) were non-vigorous. Thirty (77%) of non-vigorous infants underwent tracheal suctioning. In the no-suction era (1/2017-12/2018), 282/2918 neonates (9.7%) were born through MSAF and 30 (10.6%) were non-vigorous and one needed intubation. Admissions for meconium aspiration syndrome (15% vs 53%) and respiratory distress (18% vs 57%) were significantly higher among non-vigorous infants in the no-suction era.
In this single-center study, non-vigorous infants born through MSAF without routine-tracheal suctioning had a higher incidence of NICU admission for MAS and respiratory distress compared to the routine-suction era. Multicenter randomized trials evaluating tracheal suction in non-vigorous infants with MSAF are warranted.
评估实施无气管抽吸指南前后，羊水胎粪污染（MSAF）分娩的非活力儿的短期结局。
对≥36 周胎龄的 MSAF 新生儿进行单中心回顾性研究。
在常规抽吸时代（2013 年 9 月至 2014 年 12 月），280/2306 名（12%）新生儿通过 MSAF 分娩，其中 39 名（14%）为非活力儿。30 名（77%）非活力儿接受了气管抽吸。在无抽吸时代（2017 年 1 月至 2018 年 12 月），282/2918 名（9.7%）新生儿通过 MSAF 分娩，其中 30 名（10.6%）为非活力儿，1 名需要插管。无抽吸时代非活力儿的胎粪吸入综合征（15%比 53%）和呼吸窘迫（18%比 57%）入院率明显较高。
在这项单中心研究中，与常规抽吸时代相比，无常规气管抽吸的 MSAF 分娩的非活力儿，NICU 因 MAS 和呼吸窘迫而入院的发生率更高。需要多中心随机试验来评估 MSAF 中非活力儿的气管抽吸。
