Am J Perinatol
DOI: 10.1055/s-0041-1741034
Review

Effect of Endotracheal Suctioning on Infants Born through Meconium-Stained Amniotic Fluid: A Meta-Analysis

Qing Wei
1   Department of Obstetrics, The Third Central Hospital of Tianjin, Hedong District, Tianjin, China
2   Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
3   Department of obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin, China
4   Tianjin Institute of Hepatobiliary Disease, Tianjin, China
,
Wenjing Chen
1   Department of Obstetrics, The Third Central Hospital of Tianjin, Hedong District, Tianjin, China
2   Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
3   Department of obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin, China
4   Tianjin Institute of Hepatobiliary Disease, Tianjin, China
,
Qian Liang
1   Department of Obstetrics, The Third Central Hospital of Tianjin, Hedong District, Tianjin, China
2   Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
3   Department of obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin, China
4   Tianjin Institute of Hepatobiliary Disease, Tianjin, China
,
Shurong Song
1   Department of Obstetrics, The Third Central Hospital of Tianjin, Hedong District, Tianjin, China
2   Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
3   Department of obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin, China
4   Tianjin Institute of Hepatobiliary Disease, Tianjin, China
,
Jia Li
1   Department of Obstetrics, The Third Central Hospital of Tianjin, Hedong District, Tianjin, China
2   Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
3   Department of obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin, China
4   Tianjin Institute of Hepatobiliary Disease, Tianjin, China
› Author Affiliations
Funding None.

Abstract

Objective Meconium is a common finding in amniotic fluid and placental specimens, particularly in term and post-term pregnancies. The objective of this paper was to perform a meta-analysis to examine the impact of endotracheal suctioning on the occurrence of meconium aspiration syndrome (MAS), mortality, and complications.

Study Design PubMed, EMBASE, and the Cochrane library were systematically searched for comparative studies. Odds ratios (ORs), weighted mean differences (WMDs), and corresponding 95% confidence intervals (CIs) were used to compare the outcomes.

Results Twelve studies were included in the meta-analysis. There were no significant impacts of endotracheal suctioning on the occurrence of MAS (OR = 3.05, 95% CI: 0.48–19.56), mortality (OR = 1.25, 95% CI: 0.35–4.44), the need for mechanical ventilation (OR = 4.20, 95% CI: 0.32–54.72), the occurrence of pneumothorax (OR = 0.99, 95% CI: 0.34–2.85), persistent pulmonary hypertension of the newborn (PPHN), (OR = 1.31, 95% CI: 0.58–2.98), hypoxic-ischemic encephalopathy (HIE) (OR = 0.82, 95% CI: 0.52–1.30), and length of stay (WMD = −0.11, 95% CI: −0.99–0.77).

Conclusion Routine endotracheal suctioning at birth is not useful in preventing MAS, mortality, mechanical ventilation, PPHN, HIE, and prolonged length of stay in neonates born through MSAF.

Key Points

  • Routine suctioning is not recommended for newborns.

  • Endotracheal aspiration is not beneficial for MAS.

  • Future research may focus on selected neonates.

Data Availability Statement

The data used to support the findings of this study are available from the corresponding author upon request.


Authors' Contributions

Q.W. substantially contributed to the conception or design, acquisition, analysis, and interpretation of data. WC contributed to acquisition, analysis, interpretation of data, and drafted the manuscript for important content. QL critically revised the manuscript for important intellectual content. SS gave final approval. JL contributed to acquisition, analysis, and interpretation of data.


These authors contributed equally to this work.


Supplementary Material



Publication History

Received: 07 September 2021

Accepted: 29 November 2021

Publication Date:
11 January 2022 (online)

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