OBJECTIVE: To determine if intubation of the low-risk newborn with thin meconium affects the incidence of respiratory symptoms.METHODS: Exclusion criterion included moderate or thick meconium, fetal distress, neonatal depression or prematurity. Eligible infants were randomized to either an intubation (Group I) or to a non-intubation group(Group II). The outcome was the presence of respiratory symptoms. This study was approved by the hospital institutional review board. Chi-square, Fisher Exact test,or ANOVA used as appropriate. RESULTS: Patients were studied from May 1994 to June 1997. There were 8,967 births during this period. 7.9% (708/8,967) were delivered through meconium. Thin meconium was noted in 50.3% (356/708) of all births. 24/356 infants with thin meconium were excluded for medical criterion. 169 infants were randomized, 77 infants into Group I and 92 infants into Group II. 163 infants were medically eligible but could not be randomized due to lack of consent, late arrival of the team or obstetrician request. These were retrospectively assigned into intubation(Group IB) and non-intubation (Group IIB) groups. From the intubation groups I and IB, one required supplemental oxygen and was weaned to room air in 7 hours. From the non-intubation groups II and II B, two infants required oxygen, weaning to room air in 11 and 46 hours. Comparing birthweight, gestational age, sex, mode of delivery and 5-minute APGAR there were no significant differences. However, the intubation groups had significantly lower 1-minute APGAR scores. There were no airway morbidities reported in the intubation groups. CONCLUSION: In the infant with thin meconium and an otherwise low risk pregnancy, we were unable to demonstrate a difference in respiratory symptoms with intubation and intra-tracheal suctioning. Table

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