Clinical features and prognosis of meconium aspiration syndrome complicated by pulmonary hemorrhage in neonates

Abstract:

Objective To study the clinical features and prognosis of meconium aspiration syndrome (MAS) complicated by neonatal pulmonary hemorrhage (NPH) in neonates. Methods A retrospective analysis was performed for the clinical data of 45 neonates with MAS complicated by NPH who were admitted to the hospital from December 2015 to December 2018 (observation group). Ninety neonates with MAS who were hospitalized during the same period of time and had no pulmonary hemorrhage were enrolled as the control group. The two groups were compared in terms of clinical features and prognosis. Results The observation group had a significantly lower 1-minute Apgar score after birth than the control group (P < 0.05). Compared with the control group, the observation group had significantly higher incidence rates of persistent pulmonary hypertension of the newborn, air leak syndrome and shock and a higher rate of use of pulmonary surfactant (P < 0.05), as well as higher levels of C-reactive protein and oxygen index (OI) (P < 0.01). In the early diagnosis of NPH, OI had a sensitivity of 80.0%, a specificity of 96.7%, and an area under the receiver operating characteristic curve of 0.959 (95% confidence interval:0.929-0.988, P < 0.001) at the cut-off value of 10.05. For the children who were cured and discharged, the observation group had significantly longer duration of ventilation, duration of oxygen inhalation and length of hospital stay than the control group (P < 0.05). Conclusions Neonates with MAS complicated by NPH tend to have a longer duration of ventilation and higher incidence rates of air leak syndrome and shock. OI may be used as an index for the early diagnosis of MAS complicated by NPH.