Title | Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Kalra VK, Lee HC, Sie L, Ratnasiri AW, Underwood MA, Lakshminrusimha S |
Journal | J Perinatol |
Volume | 40 |
Issue | 1 |
Pagination | 46-55 |
Date Published | 2020 01 |
ISSN | 1476-5543 |
Keywords | Administration, Inhalation, California, Extracorporeal Membrane Oxygenation, Humans, Incidence, Infant, Newborn, Infant, Newborn, Diseases, Intensive Care Units, Neonatal, Intubation, Intratracheal, Meconium Aspiration Syndrome, Nitric Oxide, Practice Guidelines as Topic, Respiration, Artificial, Resuscitation |
Abstract | OBJECTIVE: To describe trends in the incidence and severity of meconium aspiration syndrome (MAS) around the release of revised Neonatal Resuscitation Program (NRP) guidelines in 2016. STUDY DESIGN: The California Perinatal Quality Care Collaborative database was queried for years 2013-2017 to describe the incidence and outcomes of infants with MAS. Results were analyzed based on both individual years and pre- vs. post-guideline epochs (2013-15 vs. 2017). RESULT: Incidence of MAS decreased significantly from 2013-15 to 2017 (1.02 to 0.78/1000 births, p < 0.001). Among infants with MAS, delivery room intubations decreased from 2013-15 to 2017 (44.3 vs. 35.1%; p = 0.005), but similar proportion of infants required invasive respiratory support (80.1 vs. 80.8%), inhaled nitric oxide (28.8 vs. 28.4%) or extracorporeal membrane oxygenation (0.81 vs. 0.35%). CONCLUSION: While the study design precludes confirmation of implementation of the recent NRP recommendation, there was no increase in the incidence or severity of MAS following its release. |
DOI | 10.1038/s41372-019-0529-0 |
Alternate Journal | J Perinatol |
PubMed ID | 31611615 |
Grant List | HD 072929 / / Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.) / International |