Original Article

Journal of Perinatology (2009) 29, 497–503; doi:10.1038/jp.2008.241; published online 22 January 2009

Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period

B S Singh1, R H Clark2, R J Powers1 and A R Spitzer2

  1. 1Pediatrix Medical Group, Good Samaritan Hospital, San Jose, CA, USA
  2. 2The Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA

Correspondence: Dr RH Clark, Pediatrix Medical Group, Inc., 1301 Concord Terrace, Sunrise, FL 33323-2825, USA. E-mail: reese_clark@pediatrix.com

Received 17 September 2008; Revised 18 December 2008; Accepted 19 December 2008; Published online 22 January 2009.

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Abstract

Objective:

 

The purpose of this study was to evaluate the demographic and treatment characteristics of neonates (greater than or equal to37 weeks' estimated gestational age) who were admitted to a neonatal intensive care unit (NICU) for a diagnosis of meconium aspiration syndrome (MAS) during the years 1997 to 2007. The goals in studying this group of neonates were to better estimate the magnitude of abnormal outcomes and to determine the proportion of these infants exposed to specific therapeutic interventions.

Study Design:

 

Retrospective review of an administrative de-identified data set.

Result:

 

A total of 415 772 neonates formed the starting data set and 162 075 (39%) were greater than or equal to37 weeks. Of the 162 075 term neonates, 7518 (1.8% of all neonates and 4.6% of term NICU admissions) had an admission diagnosis of MAS. In the 7518 neonates, the following outcomes were observed: 6124 (81.5%) were discharged home; 679 (9%) were acutely transferred to a higher level of intensive care; 416 (5.5%) were transferred to another clinical service within the hospital; 178 (2.4%) were transferred to another NICU for convalescent care and 88 (1.2%) died. There were 33 (0.4%) who did not have data on outcome at discharge. During the period between 2002 and 2005, acute transfer rates decreased (12.4 to 9%) and the reported rate for death remained relatively constant between 0.9 and 1.5%. There were 107 (1.4%) neonates who were treated (n=61) with, or transferred, for extracorporeal membrane oxygenation (ECMO) (n=46). Three of the sixty-one neonates (4.9%) who were treated with ECMO died.

Conclusion:

 

Term neonates who are admitted with a diagnosis of MAS continue to represent a high-risk population with significant morbidity, and they often require intensive therapies.

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