Risk factorsfor
mortality of preterm infants with meconium aspiration syndrome
Xue-Mei Zhu, MD1; Lin-Yao Shi, MD1;
Lu-Quan Li, MD1;
Lei Bao MD1
1 Neonatal Diagnosis and Treatment Center, Children’s
Hospital of Chongqing Medical University; Key Laboratory of Pediatrics
in Chongqing; Chongqing International Science and Technology Cooperation
Center for Child Development and Disorders. Chongqing, China
Corresponding author: Lei Bao MD, Department of Neonatology,
Children’s
Hospital of Chongqing Medical University, Chongqing , China.
E-mail: cqbl0046@163.com; Tel:
86-23-63635567;
Fax: 86-23-6362284
Declaration of conflicting interests : The authors report no
conflicts of interest with respect to the research, authorship, and/or
publication of this article.
Funding : The authors received no financial support for the
research.
KEYWORDS: meconium
aspiration syndrome; infant, premature;
newborn;
outcome; risk factors
Running title : Mortality of preterm infants with MAS
ABSTRACT
Purpose: Meconium aspiration syndrome as one of the devasting
conditions which remains the major cause of neonatal morbidity and
mortality. Preterm infants affected by this life-threatening disease did
not get enough attention. The aim of this study was to
identify
risk factors associated with
mortality of preterm infant
hospitalized with meconium
aspiration syndrome.
Methods: We undertook a case-control study in a neonatal
diagnosis and treatment center in China over a ten-year period. Preterm
newborns affected by meconium aspiration syndrome with early onset of
respiratory distress hospitalized in NICU were included. Variables were
compared between the non-survival group and survival group. Logistic
regression model was conducted to identify risk factors associated with
mortality.
Results: Totally 92 preterm infants were included, 31(33.7%)
died. Their median gestational age was 33.4 weeks, and their mean birth
weight was 1925.2 g.
Female[19(61.3%) vs 18(29.5%),
P=0.003], arterial blood pH[7.22(±0.13) vs 7.30(±0.12), p=0.008],
persistent pulmonary hypertension[19(61.3%) vs 21(34.4%),
P=0.014], and pulmonary hemorrhage[16(51.6%) vs 13(21.3%),
P=0.003] were associated with an increased rate of mortality. In the
logistic regression model, the risk of death were found to be
statistically associated with the following three factors: Female
[odds ratio (OR) 3.91; 95% confidence interval(CI) (1.37-11.16);
P=0.011], persistent pulmonary hypertension [OR 3.12; 95% CI
(1.10-8.89); P=0.033], and pulmonary hemorrhage [OR 4.36; 95% CI
(1.53-12.45); P=0.006].
Conclusions: The MAS-associated
fatality rates in preterm infant
was significantly high. Female,
persistent pulmonary hypertension, and pulmonary hemorrhage were
considered independent predictors of MAS-associated mortality.