Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California

J Perinatol. 2020 Jan;40(1):46-55. doi: 10.1038/s41372-019-0529-0. Epub 2019 Oct 14.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • California / epidemiology
  • Extracorporeal Membrane Oxygenation / statistics & numerical data
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology
  • Intensive Care Units, Neonatal
  • Intubation, Intratracheal / trends
  • Meconium Aspiration Syndrome / epidemiology
  • Meconium Aspiration Syndrome / therapy*
  • Nitric Oxide / administration & dosage
  • Practice Guidelines as Topic*
  • Respiration, Artificial / statistics & numerical data
  • Resuscitation / standards*

Substances

  • Nitric Oxide