{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:15:28Z","timestamp":1791357328841,"version":"4.3.1"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,1,1]]},"abstract":"<jats:p>Objective.\u2003Disagreement exists concerning the appropriate delivery room management of the airway of vigorous meconium-stained infants. Some suggest a universal approach to intubation and suctioning of the airway in all such neonates, whereas others advocate a selective approach. We performed this investigation: 1) to assess whether intubation and suctioning of apparently vigorous, meconium-stained neonates would reduce the incidence of meconium aspiration syndrome (MAS); and 2) to determine the frequency of complications from delivery room intubation and suctioning of such infants.<\/jats:p><jats:p>Methods.\u2003Inclusion criteria included: 1) gestational age \u226537 weeks; 2) birth through meconium-stained amniotic fluid of any consistency; and 3) apparent vigor immediately after birth. Subjects were randomized to be intubated and suctioned (INT) or to expectant management (EXP). Primary outcome measures included: 1) the incidence of respiratory distress, including MAS, and 2) the incidence of complications from intubation.<\/jats:p><jats:p>Results.\u2003A total of 2094 neonates were enrolled from 12 participating centers (1051 INT and 1043 EXP). Meconium-stained amniotic fluid consistency was similar in both groups. Of the 149 (7.1%) infants that subsequently demonstrated respiratory distress, 62 (3.0%) had MAS and 87 (4.2%) had findings attributed to other disorders. There were no significant differences between groups in the occurrence of MAS (INT = 3.2%; EXP = 2.7%) or in the development of other respiratory disorders (INT = 3.8%; EXP = 4.5%). Of 1098 successfully intubated infants, 42 (3.8%) had a total of 51 complications of the procedure. In all cases, the complications were mild and transient in nature.<\/jats:p><jats:p>Conclusions.\u2003Compared with expectant management, intubation and suctioning of the apparently vigorous meconium-stained infant does not result in a decreased incidence of MAS or other respiratory disorders. Complications of intubation are infrequent and short-lived.<\/jats:p>","DOI":"10.1542\/peds.105.1.1","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"1-7","source":"Crossref","is-referenced-by-count":376,"title":["Delivery Room Management of the Apparently Vigorous Meconium-stained Neonate: Results of the Multicenter, International Collaborative Trial"],"prefix":"10.1542","volume":"105","author":[{"given":"Thomas E.","family":"Wiswell","sequence":"first","affiliation":[{"name":"From the Neonatology services at Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Gannon","sequence":"additional","affiliation":[{"name":"From the Neonatology services at Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Jacob","sequence":"additional","affiliation":[{"name":"Providence Alaska Medical Center, Anchorage, Alaska;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Goldsmith","sequence":"additional","affiliation":[{"name":"West Jersey Hospital, Voorhees, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgardo","family":"Szyld","sequence":"additional","affiliation":[{"name":"Diego Paroissien Hospital, Buenos Aires, Argentina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Weiss","sequence":"additional","affiliation":[{"name":"Mercer Medical Center, Trenton, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schutzman","sequence":"additional","affiliation":[{"name":"Fitzgerald Mercy Hospital, Darby, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard M.","family":"Cleary","sequence":"additional","affiliation":[{"name":"From the Neonatology services at Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayot","family":"Filipov","sequence":"additional","affiliation":[{"name":"Flushing Hospital, Flushing, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Kurlat","sequence":"additional","affiliation":[{"name":"University Hospital, Buenos Aires, Argentina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos L.","family":"Caballero","sequence":"additional","affiliation":[{"name":"Clinicas Hospital, Asu\u0301ncion, Paraguay;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Abassi","sequence":"additional","affiliation":[{"name":"Pennsylvania Hospital, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sprague","sequence":"additional","affiliation":[{"name":"Desert Samaritan Medical Center, Phoenix, Arizona; 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