ArticleChildren (Basel, Switzerland)2019
NICU Admissions for Meconium Aspiration Syndrome before and after a National Resuscitation Program Suctioning Guideline Change.
Article in Children (Basel, Switzerland), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Tracheal suction at birth in non-vigorous neonates born through meconium-stained amniotic fluid.The Cochrane database of systematic reviews · 2021Pooled it
- Factors associated with umbilical arterial blood pH in term neonates delivered via cesarean section: A retrospective cohort study.The Journal of international medical research · 2025Article
- Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid.Children (Basel, Switzerland) · 2025Article
- Visual analysis of the research literature on extracorporeal membrane oxygenation-assisted support for respiratory failure based on CiteSpace and VOSviewer: a 20-year study.Journal of thoracic disease · 2024Article
- [The evolution of approach in the resuscitation of neonates born with meconium-stained amniotic fluid: a tale of two countries, China and U.S.A., in the past 60 years].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Review
- [Clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for severe MAS in neonates with meconium-stained amniotic fluid].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2022Article
- Routine Tracheal Intubation and Meconium Suctioning in Non-Vigorous Neonates with Meconium-Stained Amniotic Fluid: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2022Review
- Approach to the Connection between Meconium Consistency and Adverse Neonatal Outcomes: A Retrospective Clinical Review and Prospective In Vitro Study.Children (Basel, Switzerland) · 2021Article
- Neonatal and Postneonatal Pulmonary Hypertension.Children (Basel, Switzerland) · 2021Article
- [Newborn resuscitation and support of transition of infants at birth].Notfall & rettungsmedizin · 2021Review
- Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Textbook of Neonatal Resuscitation, seventh edition, does not suggest routine endotracheal suctioning for non-vigorous infants born through meconium-stained amniotic fluid. We compared 301,150 infants at ≥35 weeks' gestational age inborn at 311 Vermont Oxford Network member centers in the United States (U.S.) and admitted to neonatal intensive care units (NICU) who were born before (2013 to 2015) and after (2017) the guideline change. Logistic regression models adjusting for clustering of infants within centers were used to calculate risk ratios. NICU admissions for infants with a diagnosis of meconium aspiration syndrome (MAS) decreased from 1.8% to 1.5% (risk ratio: 0.82; 95% confidence interval: 0.68, 0.97) and delivery room endotracheal suctioning in this group decreased from 57.0% to 28.9% (0.51; 0.41, 0.62). Treatment with conventional or high frequency ventilation, inhaled nitric oxide, or extracorporeal membrane oxygenation remained unchanged 42.3% vs. 40.3% (0.95; 0.80, 1.13) among infants with MAS and 9.1% vs. 8.2% (0.91; 0.87, 0.95) among infants without MAS. The use of surfactant among infants with MAS increased from 24.6% to 30% (1.22; 1.02, 1.48). Mortality (2.6 to 2.9%, 1.12; 0.74, 1.69) and moderate/severe hypoxic-ischemic encephalopathy (5.4 to 6.8%, 1.24; 0.91, 1.69) increased slightly in 2017. Subgroup analyses of infants with 1 min Apgar scores of ≤3 found similar results. While NICU admissions for MAS and tracheal suctioning decreased after the introduction of the new guideline with no subsequent increase in severe respiratory distress among infants with and without a MAS diagnosis, limitations in our study preclude inferring that the new guideline is safe or effective.
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