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Respiratory Related Hospitalization in Children With Exposure to Meconium Aspiration or Staining
Gabriel Côté-Corriveau1,2,3, Ariane Lasry4, Philippe Bégin1
1Department of Pediatrics, Sainte-Justine Hospital Research Centre, Montreal, Quebec, Canada.
Insights
Meconium aspiration in newborns increases the risk of childhood respiratory and allergic hospitalizations. However, meconium staining without aspiration does not appear to pose the same risks.
Area of Science:
- Pediatric respiratory health
- Neonatal complications
- Allergy and immunology
Background:
- Investigating the long-term respiratory health impact of meconium exposure in neonates.
- Assessing the association between meconium exposure and childhood respiratory hospitalizations.
Purpose of the Study:
- To determine if neonates exposed to meconium have an increased risk of respiratory hospitalization in early childhood.
- To differentiate the risks associated with meconium aspiration versus meconium staining without aspiration.
Main Methods:
- Longitudinal cohort study of 1,271,563 children in Quebec, Canada (2006-2022).
- Exposure: meconium aspiration or staining without aspiration at birth.
- Outcome: hospitalization for bronchiolitis, asthma, and allergic conditions up to age 5.
- Cox regression models used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusted for covariates and stratified by gestational age.
Main Results:
- Meconium aspiration was linked to a 1.24-fold increased risk of bronchiolitis, 1.43-fold for asthma, and 1.40-fold for other allergies.
- These associations were observed in term and post-term infants but not preterm infants.
- Meconium exposure without aspiration showed a protective effect (HR 0.92), which diminished after accounting for gestational age.
Conclusions:
- Meconium aspiration is significantly associated with increased risk of respiratory and atopic complications requiring hospitalization.
- Meconium exposure without aspiration did not show a significant association with these adverse outcomes.
- Gestational age is an important factor in understanding the impact of meconium exposure on infant respiratory health.
Background:
We investigated whether neonates exposed to meconium had a higher risk of respiratory hospitalization in childhood.
Methods:
We analyzed a longitudinal cohort of 1,271,563 children with 6,334,857 person-years of follow-up between birth and age 5 years in Quebec, Canada from 2006 to 2022. The exposure was meconium aspiration or meconium staining without aspiration at birth. The outcome was hospitalization for bronchiolitis, asthma, and other allergic conditions up to age 5 years. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between meconium exposure and these outcomes using Cox regression models adjusted for patient characteristics. We additionally examined associations according to gestational age.
Results:
A total of 6050 children had meconium aspiration (0.5%) and 131,238 were exposed to meconium without aspiration (10.3%). Compared with no exposure, meconium aspiration was associated with 1.24 times the risk of bronchiolitis (95% CI: 1.09-1.42), 1.43 times the risk of asthma (95% CI: 1.20-1.69), and 1.40 times the risk of other allergy hospitalization (95% CI: 1.11-1.76). Meconium aspiration was associated with these outcomes among children born at term (HR: 1.28, 95% CI: 1.14-1.44) and post-term (HR: 1.56, 95% CI: 1.26-1.94). There was no association for children born preterm. Meconium exposure without aspiration appeared to protect against the outcomes (HR: 0.92, 95% CI: 0.90-0.95), but the association disappeared when we accounted for gestational age.
Conclusion:
Meconium aspiration is associated with a higher risk of hospitalization for respiratory or atopic complications, but meconium exposure without aspiration is not associated with these outcomes.
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