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Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California

Journal of Perinatology volume 40, pages 46–55 (2020)Cite this article

Subjects

Abstract

Objective

To describe trends in the incidence and severity of meconium aspiration syndrome (MAS) around the release of revised Neonatal Resuscitation Program (NRP) guidelines in 2016.

Study design

The California Perinatal Quality Care Collaborative database was queried for years 2013–2017 to describe the incidence and outcomes of infants with MAS. Results were analyzed based on both individual years and pre- vs. post-guideline epochs (2013–15 vs. 2017).

Result

Incidence of MAS decreased significantly from 2013–15 to 2017 (1.02 to 0.78/1000 births, p < 0.001). Among infants with MAS, delivery room intubations decreased from 2013–15 to 2017 (44.3 vs. 35.1%; p = 0.005), but similar proportion of infants required invasive respiratory support (80.1 vs. 80.8%), inhaled nitric oxide (28.8 vs. 28.4%) or extracorporeal membrane oxygenation (0.81 vs. 0.35%).

Conclusion

While the study design precludes confirmation of implementation of the recent NRP recommendation, there was no increase in the incidence or severity of MAS following its release.

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Acknowledgements

We gratefully acknowledge all site data abstractors of the California Perinatal Quality Care Collaborative (CPQCC). The project described was supported by NIH Grant (HD 072929) and Faculty development fund at UC Davis School of Medicine.

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Authors and Affiliations

  1. Department of Pediatrics, UC Davis Health System, Sacramento, CA, USA

    Vaneet K Kalra, Mark A. Underwood & Satyan Lakshminrusimha

  2. Department of Pediatrics, Stanford University, Stanford, CA, USA

    Henry C Lee & Lillian Sie

  3. Department of Cardiovascular medicine, UC Davis Health System, Sacramento, CA, USA

    Anura W Ratnasiri

Authors
  1. Vaneet K Kalra
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  2. Henry C Lee
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  3. Lillian Sie
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  4. Anura W Ratnasiri
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  5. Mark A. Underwood
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  6. Satyan Lakshminrusimha
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Contributions

VKK and SL conceptualized and designed the study, submitted IRB application, drafted and analyzed tables, drafted initial paper, and reviewed and revised the subsequent paper. HCL contributed to study design, critically reviewed and revised the paper for important intellectual content. LS contributed to study design, conducted statistical analysis, and critically reviewed and revised the paper for important intellectual content. AWR critically reviewed the paper and performed statistical analysis. MU critically reviewed and revised the paper for intellectual content. All authors approve the final paper as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Vaneet K Kalra.

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Kalra, V.K., Lee, H.C., Sie, L. et al. Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California. J Perinatol 40, 46–55 (2020). https://doi.org/10.1038/s41372-019-0529-0

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