Risk factors for meconium-aspiration syndrome

The aim of this retrospective study was to identify risk factors for meconium-aspiration syndrome, and to identify antenatal and intrapartum risk factors which might be preventable. We analyzed maternal and neonatal records of the 210 infants who had meconium-stained liquor and who also developed respiratory distress necessitating admission to the Special Care or Intensive Care Baby Units at National Women's Hospital, Auckland in 1992. Meconium-aspiration syndrome occurred in 6.6% of meconium exposed babies and in 1.3% of total births. Severe meconium-aspiration syndrome developed in 18 infants, moderate in 48, mild in 60 and transient respiratory distress in 84. An association was found between meconium aspiration syndrome and primiparity (p=0.0001) and Pacific Island ethnicity (p=0.0002). An association was also found between the severity of meconium aspiration and low umbilical artery pH (p=0.0002). Thick meconium and an abnormal cardiotocograph were more common in severe meconium-aspiration syndrome. All deaths and long-term morbidity occurred in babies with abnormal cardiotocographs or in unmonitored infants. Preventable antenatal and intrapartum factors were not identified in this study.