{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T10:39:03Z","timestamp":1792492743300,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171710, 82271749, 82201905"],"award-info":[{"award-number":["82171710, 82271749, 82201905"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The presence of meconium is associated with gestational age, and the incidence of meconium aspiration syndrome (MAS) increases with gestational age. Our study compared the differences in the clinical characteristics of patients with MAS at different gestational ages and discussed the risk factors for neurological injury and death from MAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 294 neonates diagnosed with MAS between 2013 and 2021 were included. Patients were divided into preterm, early-term, full-term, and late-term groups according to gestational age. We compared the patients\u2019 basic demographic, treatment, complications, and clinical outcomes in the different groups. We also analyzed the risk factors of neurological injury and death in patients with MAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age at admission (0.55\u2009\u00b1\u20090.9\u2005h) was lower and the proportion of cesarean deliveries (90.00%, 27\/30) was higher in the preterm group than in the other three groups. There was no statistically significant difference among the four groups regarding 1- and 5-min Apgar scores and the need for delivery room resuscitation. In terms of complications, early-term infants had the highest incidence of neurological injury (52.9%, 27\/51), and late-term infants had the highest incidence of pneumothorax (37.8%, 17\/45). The overall mortality rate of children with MAS was 7.80% (23\/294), and the difference in mortality rates among the four groups was not significant. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were independent risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The clinical characteristics of MAS neonates of different gestational age are different mainly in complications. Early-term infants are more likely to complicate with neurological injury, and late-term infants are more likely to complicate with pneumothorax. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were established as risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1110891","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T04:46:22Z","timestamp":1678164382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical characteristics of meconium aspiration syndrome in neonates with different gestational ages and the risk factors for neurological injury and death: A 9-year cohort study"],"prefix":"10.3389","volume":"11","author":[{"given":"Lei","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhi","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/01.ogx.0000149659.89530.c2","article-title":"Meconium passage in utero: mechanisms, consequences, and management","volume":"60","author":"Ahanya","year":"2005","journal-title":"Obstet Gynecol Surv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1038\/pr.2015.265","article-title":"Meconium-induced inflammation and surfactant inactivation: specifics of molecular mechanisms","volume":"79","author":"Kopincova","year":"2016","journal-title":"Pediatr Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.siny.2017.04.002","article-title":"Meconium \u201caspiration\u201d (or respiratory distress associated with meconium-stained amniotic fluid?)","volume":"22","author":"Vain","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1055\/s-0037-1620269","article-title":"Approach to infants born through meconium stained amniotic fluid: evolution based on evidence?","volume":"35","author":"Rawat","year":"2018","journal-title":"Am J Perinatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"321545","DOI":"10.1155\/2012\/321545","article-title":"A population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation","volume":"2012","author":"Fischer","year":"2012","journal-title":"Int J Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"359571","DOI":"10.1155\/2012\/359571","article-title":"Advances in the management of meconium aspiration syndrome","volume":"2012","author":"Swarnam","year":"2012","journal-title":"Int J Pediatr"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/children8030246","article-title":"Neonatal respiratory distress secondary to meconium aspiration syndrome","author":"Olicker","year":"2021","journal-title":"Children (Basel, Switzerland"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/children8030230","article-title":"Meconium aspiration syndrome: a narrative review","author":"Monfredini","year":"2021","journal-title":"Children (Basel, Switzerland)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1179\/146532808X335642","article-title":"Meconium-stained amniotic fluid and meconium aspiration syndrome: a prospective study","volume":"28","author":"Bhat","year":"2008","journal-title":"Ann Trop Paediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"28","DOI":"10.9790\/0853-1701112837","article-title":"Study of meconium aspiration syndrome and its clinical outcome in neonates","volume":"11","author":"Kumar","year":"2018","journal-title":"IOSR J Dent Med Sci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1080\/14767058.2020.1713744","article-title":"The risk of meconium aspiration syndrome (MAS) increases with gestational age at term","volume":"35","author":"Ward","year":"2022","journal-title":"J Matern-Fetal Neonatal Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.ejogrb.2013.01.026","article-title":"Prolonged and post-term pregnancies: guidelines for clinical practice from the French college of gynecologists and obstetricians (CNGOF)","volume":"169","author":"Vayssiere","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/j.earlhumdev.2009.09.011","article-title":"Pathophysiology of meconium passage into the amniotic fluid","volume":"85","author":"Poggi","year":"2009","journal-title":"Early Hum Dev"},{"key":"B14","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/jpc.14703","article-title":"Meconium aspiration syndrome: incidence, associated risk factors and outcome-evidence from a multicentric study in low-resource settings in Nepal","volume":"56","author":"Paudel","year":"2020","journal-title":"J Paediatr Child Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.5468\/ogs.2015.58.1.24","article-title":"Risk factors differentiating mild\/moderate from severe meconium aspiration syndrome in meconium-stained neonates","volume":"58","author":"Choi","year":"2015","journal-title":"Obstet Gynecol Sci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1080\/14767058.2017.1410700","article-title":"Guimar\u00e3es pereira areias MHF. Meconium aspiration syndrome: risk factors and predictors of severity","volume":"32","author":"Oliveira","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B17","volume-title":"Practical neonatology","author":"Shao","year":"2019"},{"key":"B18","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1186\/s12887-022-03603-9","article-title":"Outcome of neonatal hypoxemic respiratory failure: a livebirth population-based retrospective survey","volume":"22","author":"Ding","year":"2022","journal-title":"BMC Pediatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"F9","DOI":"10.1136\/adc.2009.178798","article-title":"Neonatal infections in England: the NeonIN surveillance network","volume":"96","author":"Vergnano","year":"2011","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B20","doi-asserted-by":"publisher","first-page":"Cd012671","DOI":"10.1002\/14651858.CD012671.pub2","article-title":"Tracheal suction at birth in non-vigorous neonates born through meconium-stained amniotic fluid","volume":"6","author":"Nangia","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.earlhumdev.2014.04.005","article-title":"Consequences of meconium stained amniotic fluid: what does the evidence tell us?","volume":"90","author":"Hutton","year":"2014","journal-title":"Early Hum Dev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e5574","DOI":"10.7759\/cureus.5574","article-title":"Factors leading to meconium aspiration syndrome in term- and post-term neonates","volume":"11","author":"Chand","year":"2019","journal-title":"Cureus"},{"key":"B23","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1038\/jp.2008.241","article-title":"Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period","volume":"29","author":"Singh","year":"2009","journal-title":"J Perinatol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"774","DOI":"10.3877\/cma.j.issn.1673-5250.2015.06.020","article-title":"Typing characteristics and determining indicators of severe meconium aspiration syndrome","volume":"11","author":"Wu","year":"2015","journal-title":"Chin J Obstet Gynecol Pediatr (Electronic Edition)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1542\/peds.2005-2215","article-title":"The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome","volume":"117","author":"Dargaville","year":"2006","journal-title":"Pediatrics"},{"key":"B26","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.earlhumdev.2009.09.013","article-title":"What (not) to do at and after delivery? Prevention and management of meconium aspiration syndrome","volume":"85","author":"Vain","year":"2009","journal-title":"Early Hum Dev"},{"key":"B27","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1055\/s-0033-1361105","article-title":"Meconium aspiration syndrome\u2013a 21-years\u2019 experience from a tertiary care center and analysis of risk factors for predicting disease severity","volume":"225","author":"Hofer","year":"2013","journal-title":"Klin Padiatr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1007\/s12098-016-2128-9","article-title":"Current concepts in the management of meconium aspiration syndrome","volume":"83","author":"Chettri","year":"2016","journal-title":"Indian J Pediatr"},{"key":"B29","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.clp.2007.10.005","article-title":"Meconium stained fluid: approach to the mother and the baby","volume":"34","author":"Walsh","year":"2007","journal-title":"Clin Perinatol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"S79","DOI":"10.1038\/jp.2008.152","article-title":"Extracorporeal membrane oxygenation: use in meconium aspiration syndrome","volume":"28","author":"Short","year":"2008","journal-title":"J Perinatol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1038\/jp.2016.32","article-title":"Surfactant therapy and antibiotics in neonates with meconium aspiration syndrome: a systematic review and meta-analysis","volume":"36","author":"Natarajan","year":"2016","journal-title":"J Perinatol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"Cd006183","DOI":"10.1002\/14651858.CD006183.pub2","article-title":"Antibiotics for neonates born through meconium-stained amniotic fluid","volume":"6","author":"Kelly","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"B33","doi-asserted-by":"publisher","first-page":"S93","DOI":"10.1038\/jp.2008.154","article-title":"Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review","volume":"28","author":"Beligere","year":"2008","journal-title":"J Perinatol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"695","DOI":"10.2011\/JCPSP.695699","article-title":"Mortality in meconium aspiration syndrome in hospitalized babies","volume":"21","author":"Anwar","year":"2011","journal-title":"J Coll Physicians Surg Pak"},{"key":"B35","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/j.jmii.2019.08.001","article-title":"Clinical features of neonatal listeriosis in Taiwan: a hospital-based study","volume":"53","author":"Tai","year":"2020","journal-title":"J Microbiol Immunol Infect"},{"key":"B36","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1186\/s12879-020-05327-6","article-title":"Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013 to 2018","volume":"20","author":"Li","year":"2020","journal-title":"BMC Infect Dis"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1110891\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T04:46:28Z","timestamp":1678164388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1110891\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,7]]},"references-count":36,"alternative-id":["10.3389\/fped.2023.1110891"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1110891","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,7]]},"article-number":"1110891"}}