ArticleCureus2024
Management and Follow-Up of a Cohort of Neonates With Meconium Aspiration Syndrome Before and After the Revision of the 2015 Neonatal Resuscitation Program.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMeconium aspiration syndrome (MAS) is a respiratory condition associated with high morbimortality. Standards of care changed over the years addressing its specificities, aiming to decrease poor respiratory and neurologic long-term outcomes. This study aims to compare the practice and outcomes of MAS in a level III neonatal intensive care unit before and after the revision of the 2015 Neonatal Resuscitation Program (NRP).
methodsA 15-year retrospective cohort of patients with MAS was assessed regarding perinatal management, clinical outcome, and neurodevelopmental follow-up.
resultsA total of 52 MAS occurred, 51.9% (n=27) male gender, median gestational age 40 weeks (IQR 39-40), and mean birth weight of 3395±503 g. Recommendations of the NRP were implemented with a significant change in the management in the delivery room, as positive pressure ventilation was more frequent (p=0.001). No significant change was found in the clinical span or morbidity of MAS after NRP, except for lower acidosis (pH 7.0 vs. 7.2; p=0.042) and lower hyperlactatemia (12.2 vs. 6.4 mmol/l; p=0.035). Overall acute complications included pulmonary hypertension (21.2%, n=11) and pneumothorax (15.4%, n=8). To date, morbidity during follow-up didn't differ after NRP concerning global development delay (p=0.591), neurologic sequelae (p=0.276), and recurrent bronchospasm (p=0.614), in contrast with speech delay, which was less frequent in the later subgroup (p=0.023).
conclusionsSAM persists as a concerning condition. From our data, the NRP showed no inferiority in the clinical outcomes, consistent with the literature but with higher frequency. Late morbidity is still a problem concerning cerebral palsy and global development delay, similar to known data.
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