![]() ![]() They did not include potentially higher-risk late preterm infants in their cohort, nor did they limit their denominator to only those classified as nonvigorous at birth or to those admitted to the NICU. Their study stands apart in that they identified and included all deliveries attended for term infants born through MSAF at their institution. They did find a decrease in the need for respiratory support after the first day of life, improvement in 1-minute Apgar scores, and a decrease in the number of delivery room intubations. 10 They found no difference among the 2 groups in NICU admission rates, length of stay, and need for respiratory support on admission. In this study, the authors examined the clinical outcomes of term (≥37 weeks’ gestational age) infants born through MSAF at a single large academic center before and after adoption of the seventh edition NRP guidelines. In this issue of Hospital Pediatrics, Myers and Gupta 10 submit another entry into the literature to help us answer these questions. Nonetheless, the results of this study added to ongoing speculation regarding the latest changes in the NRP guidelines. It is unclear if perhaps some of the nonvigorous infants in the preintervention period remained so because of attempts to withhold stimulation to perform intubation before the first cry. In this cohort study, the authors looked specifically at nonvigorous infants born through MSAF and noted that the proportion of these infants declined from 10% to 8% after adoption of the recent NRP guidelines. However, no difference in the incidence of meconium aspiration syndrome (MAS) was observed. A retrospective study conducted by Chiruvolu et al 7 revealed an increase in NICU admissions for respiratory causes and an increase in the need for mechanical ventilation, oxygen therapy, and use of surfactant after implementation of the new guidelines. Aldhafeeri et al 6 conducted a retrospective single-center study, comparing outcomes before and after implementation of the most recent NRP guidelines, and found no significant difference in meconium aspiration related complications between the 2 groups. Meconium aspiration.However, do we do more harm by intubating or by not intubating these infants? In recent studies, others have attempted to shed light on this question. A population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation. Respiratory support in meconium aspiration syndrome: A practical guide. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. We link primary sources - including studies, scientific references, and statistics - within each article and also list them in the resources section at the bottom of our articles. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. ![]() A study in the International Journal of Pediatrics estimated that about 0.18% of full-term newborns could experience this condition. MAS is a rare complication during childbirth. MAS also increases the likelihood of serious infections, such as pneumonia, which can be particularly severe in a newborn, as their immune system is not yet mature. The condition usually affects full-term newborns born at 37–41 weeks of pregnancy who are small for their gestational age or post-term newborns born after 42 weeks of pregnancy. The resulting signs include difficulty breathing and a bluish tint to the skin. The condition can become severe and cause part of the lung to collapse. If a baby breathes in amniotic fluid and meconium, these substances can reach their lungs, blocking the airways. Amniotic fluid surrounds the fetus in the uterus. Meconium passes out of the newborn’s body as their first stool. Meconium is a dark green sticky substance comprising materials that the fetus ingested while in the uterus. MAS occurs when a newborn breathes in a mixture of amniotic fluid and meconium. Share on Pinterest Image credit: Jill Lehmann Photography/Getty Images ![]()
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