Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

Abstract

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.