Results
95 preterm infants with confirmed
MAS were screened during the ten years period (Jan, 2010 to Jan, 2020),
2 case were excluded owing to missing data, 1 case were excluded owing
to extremely severe abdominal distension that his parents chose to give
up, 92 preterm neonates were finally included, consisting of 31
non-survivors and 61 survivors. The total mortality in this study was
33.7%, while female account for 40% of all involved preterm infants.
Their median gestational age was 33.4 weeks, while
their
mean birth weight was 1925.2 g.
Among all the infants, 17 (18.5%) premature infants were small for
gestational age.
Table 1 outlines the baseline features compared between the non-survival
group and survival group. Risk was substantially higher among those were
female. Compared with the survivors, infants in the non-survival group
were more likely to be in need of resuscitation. In comparison with
infants of non-chorioamnionitis mothers, infants of mothers affected by
chorioamnionitis were more likely
to die. Infants of mothers undergoing premature rupture of
membranes(>18h) were more frequently seen in the
non-survival group. Surfactant or inhaled nitric oxide were more likely
to administrated in non-survival
group. Conversely, compared with the survival group, the non-survival
group were in lower birth weight and smaller proportion of small for
gestational age. Mothers of infants in the non-survival group were less
likely to experience cesarean section and suffer from gestational
diabetes mellitus or pregnancy-induced hypertension. Potential of
hydrogen (pH) value and partial pressure of arterial oxygen
(PaO2) were lower in the survival group compared with
the non-survival group. The median durations of ventilation were 108
hours (survival group) and 48 hours (non-survival group), at the same
time the median hospitalization stay of those who survived was 23 day,
longer than that of those who dead (their median hospitalization stay
was 2 days).
Complications were compared between the two groups showed in table 2. It
is suggested that persistent pulmonary hypertension and pulmonary
hemorrhage were statistically in correlation with mortality of MAS in
preterm infants. Meanwhile, majority of complications listed such as
sepsis, necrotizing enterocolitis, pneumothorax, intracranial
hemorrhage, shock, patent ductus arteriosus, anemia, myocardial injury,
and metabolic acidosis were more frequently seen in the non-survival
group.
Table 3 shows the independent risk factors for mortality by multivariate
regression analysis. The parameters included in the regression model
were all variables significant in the univariate analysis, three risk
factors were significantly associated with mortality of MAS in preterm
infants: female (P=0.011), persistent pulmonary hypertension (P=0.033),
and pulmonary hemorrhage ( P=0.006).