Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome

Abstract Foetal hypoxia–ischaemia is a key trigger of meconium aspiration syndrome (MAS). However, many neonates develop MAS without evidence of hypoxia–ischaemia, suggesting the presence of covert but important risk variables. We evaluated the association of MAS with clinical variables, placental h...

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Autores principales:	Kyoko Yokoi, Osuke Iwata, Satoru Kobayashi, Mizuho Kobayashi, Shinji Saitoh, Haruo Goto
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/da34dc43261f4bd9ac808a6decad3120
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spelling	oai:doaj.org-article:da34dc43261f4bd9ac808a6decad31202021-12-02T18:51:47ZEvidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome10.1038/s41598-021-96275-x2045-2322https://doaj.org/article/da34dc43261f4bd9ac808a6decad31202021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96275-xhttps://doaj.org/toc/2045-2322Abstract Foetal hypoxia–ischaemia is a key trigger of meconium aspiration syndrome (MAS). However, many neonates develop MAS without evidence of hypoxia–ischaemia, suggesting the presence of covert but important risk variables. We evaluated the association of MAS with clinical variables, placental histopathologic findings, and inflammatory biomarkers at birth. Of 1336 symptomatic and asymptomatic term singleton neonates with meconium-stained amniotic fluid, 88 neonates (6.6%) developed MAS. Univariate analysis showed that MAS development was associated with low 1- and 5-min Apgar scores, low cord blood pH, funisitis, higher α1-acid glycoprotein levels, and higher haptoglobin levels (all p < 0.001 except for p = 0.001 for haptoglobin). Associations of MAS with caesarean delivery (p = 0.004), premature rupture of the membranes (p = 0.006), chorioamnionitis (p = 0.007), and higher C-reactive protein levels (p = 0.008) were lost when adjusted for multiple comparisons. The final multivariate model to explain MAS development comprised lower cord blood pH (odds ratio [OR] 0.58; 95% confidence interval [CI] 0.47–0.73; p < 0.001), funisitis (OR 2.45; 95% Cl 1.41–4.26; p = 0.002), and higher α1-acid glycoprotein levels (OR 1.02; 95% Cl 1.01–1.03; p = 0.001). Our data from a large cohort of neonates suggested that intrauterine inflammation is one of the key independent variables of MAS development, together with foetal hypoxia–ischaemia.Kyoko YokoiOsuke IwataSatoru KobayashiMizuho KobayashiShinji SaitohHaruo GotoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kyoko Yokoi Osuke Iwata Satoru Kobayashi Mizuho Kobayashi Shinji Saitoh Haruo Goto Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
description	Abstract Foetal hypoxia–ischaemia is a key trigger of meconium aspiration syndrome (MAS). However, many neonates develop MAS without evidence of hypoxia–ischaemia, suggesting the presence of covert but important risk variables. We evaluated the association of MAS with clinical variables, placental histopathologic findings, and inflammatory biomarkers at birth. Of 1336 symptomatic and asymptomatic term singleton neonates with meconium-stained amniotic fluid, 88 neonates (6.6%) developed MAS. Univariate analysis showed that MAS development was associated with low 1- and 5-min Apgar scores, low cord blood pH, funisitis, higher α1-acid glycoprotein levels, and higher haptoglobin levels (all p < 0.001 except for p = 0.001 for haptoglobin). Associations of MAS with caesarean delivery (p = 0.004), premature rupture of the membranes (p = 0.006), chorioamnionitis (p = 0.007), and higher C-reactive protein levels (p = 0.008) were lost when adjusted for multiple comparisons. The final multivariate model to explain MAS development comprised lower cord blood pH (odds ratio [OR] 0.58; 95% confidence interval [CI] 0.47–0.73; p < 0.001), funisitis (OR 2.45; 95% Cl 1.41–4.26; p = 0.002), and higher α1-acid glycoprotein levels (OR 1.02; 95% Cl 1.01–1.03; p = 0.001). Our data from a large cohort of neonates suggested that intrauterine inflammation is one of the key independent variables of MAS development, together with foetal hypoxia–ischaemia.
format	article
author	Kyoko Yokoi Osuke Iwata Satoru Kobayashi Mizuho Kobayashi Shinji Saitoh Haruo Goto
author_facet	Kyoko Yokoi Osuke Iwata Satoru Kobayashi Mizuho Kobayashi Shinji Saitoh Haruo Goto
author_sort	Kyoko Yokoi
title	Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
title_short	Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
title_full	Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
title_fullStr	Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
title_full_unstemmed	Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
title_sort	evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/da34dc43261f4bd9ac808a6decad3120
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Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome

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