Respiratory distress in vigorous babies born through meconium stained amniotic fluid: incidence, onset, risk factors and predictors at birth

Kulkarni Poornima Prakash, Shilpa Dinesh B. K.


Background: One in every seven pregnancies ends with meconium-stained amniotic fluid (MSAF). MSAF can be harmful to the newborn with short and long-term sequelae. This study was aimed to find out the incidence, predictors, onset and severity of respiratory distress among vigorous babies born through meconium stained amniotic fluid which may or may not be evident at birth.

Methods: It is a prospective observational study. One hundred forty-one neonates were studied. Data was collected on perinatal risk factors, clinical course and development of respiratory distress. Significance of the perinatal risk factors were identified by fisher’s exact test (p-value) and score based on odds ratio was assigned for significant risk factors.

Results: This study included one hundred and forty-one vigorous babies born through meconium stained amniotic fluid, of which 36.9% (52) babies developed respiratory distress. Of the 52 babies who developed respiratory distress 19.23%(10 babies) developed meconium aspiration syndrome (MAS). In our study, it was observed factors like caesarean section and thick meconium increased risk of respiratory distress in the neonates born through meconium stained amniotic fluid who were vigorous.

Conclusions: The incidence of respiratory distress in vigorous babies born through meconium stained liquor in this study was observed to be 36.9% (52 babies). 98.07% (51 babies) developed respiratory distress at birth or within one hour of life. All the babies who developed MAS had mild or moderate form of MAS. None of the babies required assisted ventilation. Risk factors like thick meconium, caesarean section showed significant increase in the incidence of respiratory distress. Therefore intrapartum monitoring and timely intervention can prevent the complications of MAS.


Respiratory distress, Meconium stained amniotic fluid, MAS, Vigorous neonate

Full Text:



Vain NE, Szyld EG, Prudent LM, Wiswell TE, Aguilar AM, Vivas NI. Oropharyngeal and nasopharyngeal suctioning of meconium-stained neonates before delivery of their shoulders: multicentre, randomised controlled trial. Lancet. 2004;364(9434):597-602.

Velaphi S, Vidyasagar D. Intrapartum and post delivery management of infants born to mothers with meconium stained amniotic fluid: evidence-based recommendations. Clinics Perinatology. 2006;33(1):29-42.

Dargaville PA, Copnell B. The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapy and outcome. Pediatrics. 2006;117(5):1712-21.

Cleary GM, Wiswell TE. Meconium-stained amniotic fluid and the meconium aspiration syndrome: an update. Pediatric Clinics North America. 1998;45(3):511-29.

Ierland YV, Boer M, Beaufort AJ. Meconium-stained amniotic fluid: discharge vigorous newborns. Arch Dis Child Fetal Neonatal. 2010;95(1):69-71.

Ross MG. Meconium aspiration syndrome more than intrapartum meconium. New England J Medicine. 2005;353(9):946-8.

Singh SN, Srivastava R, Singh A, Tahazzul M, Kumar M, Kanta C, Chandra S. Respiratory distress including meconium aspiration syndrome in vigorous babies born through meconium stained amniotic fluid: incidence, onset and severity of predictors. Indian J Pediatr. 2013;80(7):538-43.

Khazardoo US, Hantoushzadeh S, Khooshideh M, Borna S. Risk factors for meconium aspiration in meconium stained amniotic fluid. J Obstet Gynaecol. 2007;27(6):577-9.

Wiswell TE, Gannon CM, Jacob J. Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial. Pediatrics. 2000;105(1):1-7.

Singh M. Care of the newborn. 7th edition. Sagar Publications; New Delhi. 2010:277-81.

John P, Eric C, Anne R, Ann R. Meconium aspiration; manual of neonatal care. 7th edition. Lippincott Williams and Wilkins. New Delhi. 2012:429-34.