BackgroundThe presence of meconium is associated with gestational age, and the incidence of meconium aspiration syndrome (MAS) increases with gestational age. Our study compared the differences in the clinical characteristics of patients with MAS at different gestational ages and discussed the risk factors for neurological injury and death from MAS.MethodsA total of 294 neonates diagnosed with MAS between 2013 and 2021 were included. Patients were divided into preterm, early-term, full-term, and late-term groups according to gestational age. We compared the patients’ basic demographic, treatment, complications, and clinical outcomes in the different groups. We also analyzed the risk factors of neurological injury and death in patients with MAS.ResultsThe mean age at admission (0.55 ± 0.9 h) was lower and the proportion of cesarean deliveries (90.00%, 27/30) was higher in the preterm group than in the other three groups. There was no statistically significant difference among the four groups regarding 1- and 5-min Apgar scores and the need for delivery room resuscitation. In terms of complications, early-term infants had the highest incidence of neurological injury (52.9%, 27/51), and late-term infants had the highest incidence of pneumothorax (37.8%, 17/45). The overall mortality rate of children with MAS was 7.80% (23/294), and the difference in mortality rates among the four groups was not significant. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were independent risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS.ConclusionThe clinical characteristics of MAS neonates of different gestational age are different mainly in complications. Early-term infants are more likely to complicate with neurological injury, and late-term infants are more likely to complicate with pneumothorax. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were established as risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS.

中文翻译：

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不同胎龄新生儿胎粪吸入综合征的临床特征及神经损伤和死亡的危险因素：一项为期9年的队列研究

背景 胎粪的存在与胎龄有关，胎粪吸入综合征 (MAS) 的发生率随胎龄增加而增加。本研究比较不同孕周MAS患者临床特征的差异，探讨MAS神经损伤和死亡的危险因素。方法纳入2013年至2021年诊断为MAS的新生儿294例。根据胎龄将患者分为早产组、早产组、足月组和晚产组。我们比较了不同组患者的基本人口统计学、治疗、并发症和临床结果。我们还分析了 MAS 患者神经损伤和死亡的危险因素。结果入院时的平均年龄 (0.55 ± 0.9 h) 较低，剖宫产比例 (90. 00%, 27/30) 在早产组中高于其他三组。在 1 分钟和 5 分钟的 Apgar 评分以及产房复苏的需要方面，四组之间没有统计学上的显着差异。并发症方面，早产儿神经损伤发生率最高（52.9%，27/51），晚产儿气胸发生率最高（37.8%，17/45）。MAS患儿总死亡率为7.80%（23/294），四组死亡率差异无统计学意义。低 1 分钟 Apgar 评分和胎龄、代谢性酸中毒和呼吸衰竭是神经损伤的独立危险因素；代谢性酸中毒、呼吸衰竭和败血症是 MAS 新生儿死亡的独立危险因素。结论不同孕周MAS新生儿的临床特点存在差异，主要表现在并发症方面。早产儿更易并发神经损伤，晚产儿更易并发气胸。低 1 分钟 Apgar 评分和胎龄、代谢性酸中毒和呼吸衰竭被确定为神经损伤的危险因素；代谢性酸中毒、呼吸衰竭和败血症是 MAS 新生儿死亡的独立危险因素。和呼吸衰竭被确定为神经损伤的危险因素；代谢性酸中毒、呼吸衰竭和败血症是 MAS 新生儿死亡的独立危险因素。和呼吸衰竭被确定为神经损伤的危险因素；代谢性酸中毒、呼吸衰竭和败血症是 MAS 新生儿死亡的独立危险因素。