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Neonatal outcomes of non-vigorous neonates with meconium-stained amniotic fluid before and after change in tracheal suctioning recommendation

Journal of Perinatology volume 42, pages 769–774 (2022)Cite this article

Subjects

Abstract

Objective

To evaluate the short-term outcomes of non-vigorous infants born through meconium-stained amniotic fluid (MSAF) before and after implementation of no-tracheal suctioning guidelines.

Study design

Single-center retrospective study of ≥36-week gestation neonates with MSAF.

Results

During routine-suction era (9/2013–12/2014), 280/2306 neonates (12%) were born through MSAF and 39 (14%) were non-vigorous. Thirty (77%) of non-vigorous infants underwent tracheal suctioning. In the no-suction era (1/2017–12/2018), 282/2918 neonates (9.7%) were born through MSAF and 30 (10.6%) were non-vigorous and one needed intubation. Admissions for meconium aspiration syndrome (15% vs 53%) and respiratory distress (18% vs 57%) were significantly higher among non-vigorous infants in the no-suction era.

Conclusions

In this single-center study, non-vigorous infants born through MSAF without routine-tracheal suctioning had a higher incidence of NICU admission for MAS and respiratory distress compared to the routine-suction era. Multicenter randomized trials evaluating tracheal suction in non-vigorous infants with MSAF are warranted.

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Fig. 1: Difficulties in interpreting before-and-after studies with implementation of no-routine tracheal suctioning guidelines for infants born through meconium-stained amniotic fluid (MSAF).

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Funding

Funded by HD072929 (SL).

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Authors and Affiliations

  1. Department of Pediatrics, University of California at Davis, Sacramento, CA, USA

    Vaneet Kalra, Alexandra J. Leegwater, Pranjali Vadlaputi, Pranav Garlapati & Satyan Lakshminrusimha

  2. Department of Pediatrics, Central Michigan University, Children’s Hospital of Michigan, Detroit, MI, USA

    Sanjay Chawla

Authors
  1. Vaneet Kalra
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  3. Pranjali Vadlaputi
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Contributions

VK: Conception, data analysis and interpretation, paper draft, critical revision; AL: Data collection, article draft, critical revision; PV: Data collection, data analysis and interpretation; PG: Data collection, data analysis and interpretation, paper draft; SC: Critical revision; SL: Critical revision and final approval.

Corresponding author

Correspondence to Alexandra J. Leegwater.

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Competing interests

The authors declare no competing interests. Dr SL is a member of the American Academy of Pediatrics (AAP)—Neonatal Resuscitation Program (NRP) steering committee. The views expressed in this paper are his own and do not reflect the official position of the AAP or NRP.

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Kalra, V., Leegwater, A.J., Vadlaputi, P. et al. Neonatal outcomes of non-vigorous neonates with meconium-stained amniotic fluid before and after change in tracheal suctioning recommendation. J Perinatol 42, 769–774 (2022). https://doi.org/10.1038/s41372-021-01287-0

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