Comparison of neonatal outcomes of term neonates with meconium-stained amniotic fluid before and after routine endotracheal suctioning strategy at birth.

To compare the incidence of meconium aspiration syndrome (MAS) among neonates born through meconium-stained amniotic fluid (MSAF) before and after discontinuation of endotracheal suctioning for non-vigorous neonates.We conducted a multicenter retrospective cohort study across three centers comparing two eras. Neonates born through MSAF at ≥36 weeks' gestation were included. Multivariable regression adjusted for sex and birth center.Among 8635 neonates (5554 Era 1; 3081 Era 2), including 1053 non-vigorous neonates, unadjusted MAS incidence did not differ between eras overall (4.8% vs. 5.5%, p = 0.17) or among non-vigorous neonates (21.0% vs. 22.8%, p = 0.55). After adjustment, Era 2 was associated with higher odds of MAS overall (aOR 1.37, 95% CI 1.11-1.69) and among non-vigorous neonates (aOR 1.54, 95% CI 1.07-2.22). Respiratory distress was higher in Era 2, while other outcomes assessed were unchanged.Discontinuation of routine suctioning was associated with increased MAS incidence among neonates born through MSAF.

Duke Scholars

Author Rachel Gottron Greenberg Pediatrics, Neonatology