태변흡입증후군 생존 환아에서 발생하는 하기도질환의 양상 및 위험 인자
Pattern and risk factor of lower respiratory illness in children who survived meconium aspiration syndrome
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Purpose: Meconium aspiration syndrome (MAS) occurs when aspiration of meconium itself or meconium-stained amniotic fluid enters into the airways. The relationship between MAS and how they affect the respiratory outcome after recovery from MAS remains unknown. The purpose of this study was to determine the type of lower respiratory tract illness (LRTI) in those surviving MAS survivors and to find out whether any clinical findings or treatment determine the type of LRTI. Methods: We used the Catholic Medical Center’s clinical data warehouse to review data from 4 university hospitals. We first included 1,331 newborns born between March 2016 and February 2021 with diagnostic codes including labor and delivery complicated by fetal stress (distress), intrauterine hypoxia, and neonatal aspiration syndromes. We finally included 239 patients who visited the out-patient clinic with diagnosis of pneumonia, acute bronchitis, acute bronchiolitis, and asthma, according to the Korean Standard Classification of Diseases. Results: We observed a significantly higher number and fraction of eosinophils at birth in the bronchitis group. We also found significantly lower levels of white blood cells in the asthma group. After a regression analysis, we found that mechanical ventilation and steroid usage for treatment for of MAS was significantly related to bronchitis, and that antibiotics treatment acted as a protective factor for bronchiolitis. Conclusion: Laboratory findings and treatment at birth in infants with MAS appear to have impact on determining LRTI in those who survived MAS.
Abstract
Purpose: Meconium aspiration syndrome (MAS) occurs when aspiration of meconium itself or meconium-stained amniotic fluid enters into the airways. The relationship between MAS and how they affect the respiratory outcome after recovery from MAS remains unknown. The purpose of this study was to determine the type of lower respiratory tract illness (LRTI) in those surviving MAS survivors and to find out whether any clinical findings or treatment determine the type of LRTI. Methods: We used the Catholic Medical Center’s clinical data warehouse to review data from 4 university hospitals. We first included 1,331 newborns born between March 2016 and February 2021 with diagnostic codes including labor and delivery complicated by fetal stress (distress), intrauterine hypoxia, and neonatal aspiration syndromes. We finally included 239 patients who visited the out-patient clinic with diagnosis of pneumonia, acute bronchitis, acute bronchiolitis, and asthma, according to the Korean Standard Classification of Diseases. Results: We observed a significantly higher number and fraction of eosinophils at birth in the bronchitis group. We also found significantly lower levels of white blood cells in the asthma group. After a regression analysis, we found that mechanical ventilation and steroid usage for treatment for of MAS was significantly related to bronchitis, and that antibiotics treatment acted as a protective factor for bronchiolitis. Conclusion: Laboratory findings and treatment at birth in infants with MAS appear to have impact on determining LRTI in those who survived MAS.
참고문헌 (23)
- Yeung T, "Steroids for the management of neonates with meconium aspiration syndrome : a systematic review and meta-analysis", Indian Pediatr, 58, pp.370~376 (2021)
- Macfarlane PI, "Pulmonary function in children after neonatal meconium aspiration syndrome", Arch Dis Child, 63, pp.368~372 (1988)
- El Shahed AI, "Surfactant for meconium aspiration syndrome in term and late preterm infants", Cochrane Database Syst Rev, 2014, pp.CD002054~ (2014)
- Pandita A, "Effect of nasal continuous positive airway pressure on infants with meconium aspiration syndrome : a randomized clinical trial", JAMA Pediatr, 172, pp.161~165 (2018)
- Vain NE, "Meconium"aspiration"(or respiratory distress associated with meconium-stained amniotic fluid?)", Semin Fetal Neonatal Med, 22, pp.214~219 (2017)
- Yang J, "Lung function of adults born at very low birth weight", Pediatrics, 145, pp.e20192359~ (2020)
- Fischer C, "A population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation", Int J Pediatr, 2012, pp.321545~ (2012)
- Tyler DC, "Mechanical and chemical damage to lung tissue caused by meconium aspiration", Pediatrics, 62, pp.454~459 (1978)
- van Ierland Y, "Why does meconium cause meconium aspiration syndrome? Current concepts of MAS pathophysiology", Early Hum Dev, 85, pp.617~620 (2009)
- Vidyasagar D, "Studies of meconium-induced lung injury : inflammatory cytokine expression and apoptosis", J Perinatol, 28(Suppl 3), pp.S102~S107 (2008)
- Burri PH, "Structural aspects of postnatal lung development-alveolar formation and growth", Biol Neonate, 89, pp.313~322 (2006)
- Khan AM, "Meconium aspiration produces airway hyperresponsiveness and eosinophilic inflammation in a murine model", Am J Physiol Lung Cell Mol Physiol, 283, pp.L785~L790 (2002)
- Junge KM, "The LINA cohort : cord blood eosinophil", basophil progenitors predict respiratory outcomes in early infancy, 2014, pp.152, 68~76
- Phattraprayoon N, "The effects of different types of steroids on clinical outcomes in neonates with meconium aspiration syndrome : a systematic review, meta-analysis and GRADE assessment", Medicina(Kaunas), 57, pp.1281~ (2021)
- Autilio C, "Surfactant injury in the early phase of severe meconium aspiration syndrome", Am J Respir Cell Mol Biol, 63, pp.327~337 (2020)
- Haakonsen Lindenskov PH, "Meconium aspiration syndrome : possible pathophysiological mechanisms and future potential therapies", Neonatology, 107, pp.225~230 (2015)
- Haataja P, "Hospital admissions for lower respiratory tract infections after early-, late-, and post-term birth", Paediatr Perinat Epidemiol, 34, pp.139~149 (2020)
- Vazquez Nava F, "Meconium aspiration syndrome, parental atopy and asthma symptoms in children under two years old", Rev Alerg Mex, 53, pp.130~135 (2006)
- Natarajan CK, "Surfactant therapy and antibiotics in neonates with meconium aspiration syndrome : a systematic review and meta-analysis", J Perinatol, 36(Suppl 1), pp.S49~S54 (2016)
- Kelly LE, "Antibiotics for neonates born through meconium-stained amniotic fluid", Cochrane Database Syst Rev, 6, pp.CD006183~ (2017)
- Tamburini S, "The microbiome in early life : implications for health outcomes", Nat Med, 22, pp.713~722 (2016)
- Semic-Jusufagic A, "Assessing the association of early life antibiotic prescription with asthma exacerbations, impaired antiviral immunity, and genetic variants in 17q21 : a population-based birth cohort study", Lancet Respir Med, 2, pp.621~630 (2014)
- Okazaki K, "Serum cytokine and chemokine profiles in neonates with meconium aspiration syndrome", Pediatrics, 121, pp.e748~e753 (2008)