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. (261)
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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>
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