Risk Factors of Neonatal Death in Meconium Aspiration Syndrome at Trang Hospital

Abstract

Background:  Meconium aspiration syndrome       ( MAS ) is an important cause of  acute respiratory distress in newborn , which has serious complication and high mortality rate. Objectives: To determine the incidence , outcome and complications of infants with MAS and prognostic factors of this conditions at Trang Hospital. Methods: This study was a retrospective descriptive study. Medical records of infants who diagnosed with MAS at Trang hospital  between  1^st October 2016 and 30^nd September 2019 were reviewed. Data on maternal and neonatal demographics , clinical course  and outcome were recorded. Results:  Meconium stained amniotic fluid (MSAF) was found in 556  neonates. Two hundred three neonates   of  MAS cases  were  enrolled , (36.5% of MSAF) , one hundred and fifty-nine newborn was born at Trang Hospital The incidence of MAS was 14.76 per 1000 live birth. Fifteen cases of MAS died ( mortality 7.4%) and  38.9% of MAS needed mechanical ventilation. The most common cause of death was persistent pulmonary hypertension of newborn (PPHN, 100 % ).  Other cause was sepsis ( 87.6%). The significant poor prognostic factor of MAS  were non vigorous neonate , APGAR score at 1 min and at 5 min < 3 , on mechanical ventilation , MAS with complication : PPHN , sepsis , birth asphyxia , pneumothorax and pulmonary hemorrhage. Conclusions:  Incidence of MAS during this period at Trang Hospital was 14.76  per 1000 live birth. The mortality rate was 7.4%. Poor prognostic factor was non vigorous neonate, severe birth asphyxia , on mechanical ventilation , PPHN , sepsis , pneumothorax  and pulmonary hemorrhage  The most common cause of death was PPHN.