Frequency and Risk Factors of Meconium Aspiration Syndrome in Babies Delivered to Mothers with Meconium Stained Amniotic Fluid

Article Information

Title: Frequency and Risk Factors of Meconium Aspiration Syndrome in Babies Delivered to Mothers with Meconium Stained Amniotic Fluid

Authors: Sidra Tanveer, Faisal Basheer, Arshad Khushdil, Fady MA Motlaq, Raazia Nawaz, Maria Javed

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: Supplementary 2

Language: English

DOI: 10.51253/pafmj.v72iSUPPL-2.3184

Keywords: Meconium Stained Amniotic Fluidmembrane ruptureMeconium Aspiration Syndrome

Abstract

Objective
To determine the frequency and risk factors of meconium aspiration syndrome in babies delivered to mothers with meconium stained amniotic fluid attending neonatal unit of tertiary care hospital.&nbsp;
Study design
Prospective cross sectional study&nbsp;
Place and duration of study
Neonatal Unit “Pak Emirates Military Hospital”, Rawalpindi from 1st January to 30th September 2018
Patients and methods
All pregnant women with cephalic presentations with either spontaneous vaginal delivery (SVD) or lower segment cesarian section (LSCS) mode of delivery and having light-yellow to thick dark-green color liquor after spontaneous or artificial rupture of membrane were enrolled. Meconium aspiration syndrome along with risk factors like gestational age, weight, gender, mode of delivery, grades of meconium, and mortality was noted.&nbsp;
Results
Of 384 patients, meconium aspiration syndrome was observed in 37 (9.6%) patients. Meconium aspiration syndrome was 2.97 times higher among patients with &gt;36 weeks of gestation (AOR: 2.97, 95% CI: 1.12-7.89), 61% higher among patients with ≤3 kg weight (AOR: 0.39, 95% CI: 0.19-0.85), 89% higher among females (AOR: 1.89, 95% CI: 0.91-3.95), 83% higher among patients with SVD (AOR: 1.83, 95% CI: 0.89-3.75), 4.12 times higher among patients with grade III (AOR: 4.12, 95% CI: 0.51-33.45) and 8.65 times higher among patients with grade II color liquor (AOR: 8.65, 95% CI: 1.11-67.45).&nbsp;
Conclusion
Meconium aspiration syndrome frequency was found considerably higher. In particular, newborn having higher gestational age, increased weight, female gender, SVD as the mode of delivery, grade III and grade II meconium were reported as the significant risk-factors.

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Research Objective

To determine the frequency and risk factors of meconium aspiration syndrome in babies delivered to mothers with meconium-stained amniotic fluid attending a neonatal unit of a tertiary care hospital.

Methodology

Cross-sectional analytical study conducted at the Neonatal Unit of Pak Emirates Military Hospital, Rawalpindi, from January to September 2018. Pregnant women with cephalic presentations and meconium-stained amniotic fluid (light-yellow to thick dark-green) were enrolled. Meconium aspiration syndrome and risk factors such as gestational age, weight, gender, mode of delivery, and grades of meconium were recorded. Statistical analysis included frequency, percentages, and binary logistic regression.

Methodology Flowchart

                        graph TD;
    A["Enroll pregnant women with meconium-stained amniotic fluid"] --> B["Collect data on MAS and risk factors"];
    B --> C["Analyze data using SPSS"];
    C --> D["Identify significant risk factors using logistic regression"];
    D --> E["Report findings on frequency and risk factors of MAS"];

Discussion

The study highlights a considerable frequency of meconium aspiration syndrome (MAS) in the studied cohort. Several risk factors identified, such as higher gestational age, female gender, SVD, and higher grades of meconium, align with previous research. The findings suggest that while MAS remains a challenge, improvements in prenatal and intrapartum care are crucial, especially in developing nations.

Key Findings

Meconium aspiration syndrome was observed in 37 (9.6%) out of 384 patients. Risk factors associated with a higher incidence of MAS included gestational age >36 weeks (AOR: 2.97), female gender (AOR: 1.89), spontaneous vaginal delivery (SVD) (AOR: 1.83), and grade II (AOR: 8.65) and grade III (AOR: 4.12) meconium. Lower weight (<3 kg) was associated with a lower risk (AOR: 0.39). Mortality was observed in 18.9% of MAS cases.

Conclusion

Meconium aspiration syndrome was present in a significant number of newborns. Higher gestational age, increased weight, female gender, SVD as the mode of delivery, and grade-III and grade-II meconium were identified as significant risk factors. Further large-scale prospective studies are recommended.

Fact Check

1. Frequency of MAS: The study reported meconium aspiration syndrome in 37 out of 384 patients, which is 9.6%.
2. Gestational Age Risk: MAS was 2.97 times higher among patients with >36 weeks of gestation (AOR: 2.97).
3. Study Period: The study was conducted from January to September 2018.

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