Authors: S N Singh Roli Srivastava Anita Singh M Tahazzul Mala Kumar Chandra Kanta S Chandra
Publish Date: 2012/11/28
Volume: 80, Issue: 7, Pages: 538-543
Abstract
This study aimed to find out incidence predictors onset and severity of respiratory distress including meconium aspiration syndrome MAS among vigorous neonates born through meconium stained amniotic fluid MSAF which may or may not be evident at birthTwo hundred ninety vigorous neonates were studied Data were collected on perinatal risk factors clinical course and development of respiratory distress Predictors of respiratory distress were identified by logistic regression and a score based on adjusted OR was assigned for each Diagnostic performance of the score 0–24 was assessed on another 247 vigorous neonates using receiver operator characteristic analysis ROCRespiratory distress developed in 97334 infants MAS in 75259 The distress appeared within 12 h in 979 was severe in only 217 Of 10 risk factors significantly associated with respiratory distress seven entered in regression analysis Fetal distressadj OR = 118 95CI = 62–225 prolonged laboradj OR = 52 95CI = 25–107 and absent/poor cryadj OR = 56 95CI = 24–133 were identified as independent predictors each assigned a score of 12 6 and 6 respectively To predict respiratory distress a cutoff score of 9 points had sensitivity741 95CI = 633 –827 specificity846 95 CI = 779 –896 positive predictive value 716 95CI = 608 –804 negative predictive value 862 95 CI = 796 –909 likelihood ratio LR + ve 4895CI = 33–70 and LRve 0395CI = 02–04Respiratory distress occurred in one third neonates mostly had onset within 12 h of birth and it was mild to moderate in majority Fetal distress prolonged labor and absent/poor cry predicted respiratory distress and were validated However larger studies in different settings are required to confirm its utilitySNS conceived and supervised the study and prepared the manuscript He will act as guarantor of the study RS AS MT and SC collected data analysed and helped in manuscript writing MK and CK supervised the study and critically reviewed the manuscript The final manuscript was approved by all authors
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