A case-control review of neonates with Meconium Aspiration Syndrome admitted to a Tertiary Hospital in Johannesburg, South Africa
Date
2019
Authors
Jones, Lara Alexandra
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Abstract
Background: Neonates with meconium aspiration syndrome (MAS) represent a highrisk
population. This study demonstrates the morbidity and mortality profile
associated with this condition.
Objectives: To isolate characteristics, complications and outcomes of neonates with
MAS admitted to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and
compare them with neonates born without MAS.
Methods: The study was a case-control retrospective review of neonates admitted to
the CMJAH neonatal unit between 1 January 2013 and 30 April 2015.
Results: A total of 608 neonates were analysed. All cases were compared to the
control group. The overall incidence of MAS was 7.6%. Neonates born with MAS
had a higher mortality than controls (12.2% vs. 2.6%; p=0.001). Sixty-eight percent
of neonates ventilated with MAS died. Neonates born with MAS were more likely to
have a higher mean birth weight (3.1 kg vs. 2.6 kg) and to be term/post term (39.2
weeks vs. 36.2 weeks). Significantly more neonates with MAS were born small for
gestational age compared to the control group (24.6% vs. 19.0%). Neonates with
MAS were more likely to have poor Apgars (25.7% vs. 14.9%; p=0.001) and require
ventilation (35.9% vs. 5.6%; p<0.001). Complications were higher in neonates born
with MAS when compared to controls and included pneumothoraces (2.3% vs. 0.3%;
p=0.003, PPHN (14.5% vs. 1%; p=0.001) and overall sepsis (13.3% vs. 7.6%;
p=0.02). Factors associated with an increased mortality in the neonates with MAS
were the development of HIE (p=0.001), PPHN (p=0.001) and the use of inotropes
(p=0.001).
Conclusion: Meconium aspiration syndrome is an important cause of morbidity and
mortality in a resource limited setting.
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Description
A research report submitted to the Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of the Master of Medicine in the branch of Paediatrics
24 January 2019
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Citation
Jones, Lara Alexandra (2019) A case-control review of neonates with Meconium Aspiration Syndrome admitted to a Tertiary Hospital in Johannesburg, South Africa, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/29914>