Long-Term Pulmonary and Neurodevelopmental Outcomes of Meconium Aspiration Syndrome Affected Infants: A Retrospective National Population-Based Study in Taiwan

Neonatology Pub Date : 2024-05-24 DOI:10.1159/000538925
Shang-Po Shen, Yin-Ting Chen, Hsiao-Yu Chiu, M. Tsai, Hao-Wen Cheng, Kuang-Hua Huang, Yu-Chia Chang, Hung-Chih Lin
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Abstract

Introduction: Meconium aspiration syndrome (MAS) may cause severe pulmonary and neurologic injuries in affected infants after birth, leading to long-term adverse pulmonary or neurodevelopmental outcomes. Methods: This retrospective population-based cohort study enrolled 1,554,069 mother-child pairs between 2004 and 2014. A total of 8,049 infants were in the MAS-affected group, whereas 1,546,020 were in the healthy control group. Children were followed up for at least 3 years. According to respiratory support, MAS was classified as mild, moderate, and severe. With the healthy control group as the reference, the associations between MAS severity and adverse pulmonary outcomes (hospital admission, intensive care unit (ICU) admission, length of hospital stay, or invasive ventilator support during admission related to pulmonary problem) or adverse neurodevelopmental outcomes (cerebral palsy, needs for rehabilitation, visual impairment, or hearing impairment) were accessed. Results: MAS-affected infants had a higher risk of hospital and ICU admission and longer length of hospital stay, regardless of severity. Infants with severe MAS had a higher risk of invasive ventilator support during re-admission (odds ratio: 17.50, 95% confidence interval [CI]: 7.70–39.75, p < 0.001). Moderate (hazard ratio [HR]: 1.66, 95% CI: 1.30–2.13, p < 0.001) and severe (HR: 4.94, 95% CI: 4.94–7.11, p < 0.001) MAS groups had a higher risk of adverse neurodevelopmental outcome, and the statistical significance remained remarkable in severe MAS group after adjusting for covariates (adjusted HR: 2.28, 95% CI: 1.54–3.38, p < 0.001) Conclusions: Adverse pulmonary or neurodevelopmental outcomes could occur in MAS-affected infants at birth. Close monitoring and follow-up of MAS-affected infants are warranted.
受胎粪吸入综合征影响的婴儿的长期肺部和神经发育结果:台湾一项基于全国人口的回顾性研究
导言:胎粪吸入综合征(MAS)可能会在患儿出生后造成严重的肺部和神经损伤,导致长期不良的肺部或神经发育后果。研究方法这项以人群为基础的回顾性队列研究在 2004 年至 2014 年间登记了 1,554,069 对母婴。受 MAS 影响的婴儿组共有 8,049 名,而健康对照组则有 1,546,020 名。对患儿进行了至少 3 年的随访。根据呼吸支持情况,MAS 被分为轻度、中度和重度。以健康对照组为参照,研究了MAS严重程度与肺部不良后果(入院、入住重症监护室(ICU)、住院时间或入院期间与肺部问题有关的有创呼吸机支持)或神经发育不良后果(脑瘫、康复需求、视力障碍或听力障碍)之间的关联。结果显示无论病情严重与否,受 MAS 影响的婴儿入院和入住重症监护室的风险更高,住院时间更长。重度 MAS 婴儿再次入院时使用侵入性呼吸机支持的风险更高(几率比:17.50,95% 置信区间 [CI]:7.70-39.75,P <0.001)。中度(危险比[HR]:1.66,95% CI:1.30-2.13,p <0.001)和重度(HR:4.94,95% CI:4.94-7.11,p <0.001)MAS组发生不良神经发育结局的风险更高,在调整协变量后,重度MAS组的统计学意义仍然显著(调整后的HR:2.28,95% CI:1.54-3.38,p <0.001):受MAS影响的婴儿在出生时可能会出现肺部或神经发育方面的不良后果。有必要对受MAS影响的婴儿进行密切监测和随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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