ROLE OF STEROIDS IN MECONIUM ASPIRATION SYNDROME

Abstract

Background: Meconium aspiration syndrome (MAS) is a significant contributor to neonatal respiratory morbidity especially in low-resource countries. Corticosteroids can potentially play a therapeutic role since inflammation plays a role in its pathophysiology.

Objective: To compare the efficacy of intravenous methylprednisolone and nebulized beclomethasone in improving clinical outcomes in neonates with moderate to severe MAS.

Methods: This was a randomized and blinded controlled trial which was conducted at the Department of Neonatology, Children Hospital Lahore during March 2022 to October 2022. A group of one hundred and ten (>35 weeks gestation) neonates with moderate or severe MAS, were randomly randomized to three (control (n=36), intravenous methylprednisolone n=37), and nebulized beclomethasone (n=37). The primary results were the positively affecting respiratory distress (Downes score and respiratory rate), the duration of respiratory distress, and oxygen demand. The secondary outcomes were duration of stay in the hospital, mechanical ventilation and mortality. Statistical analysis was done with SPSS v27, ANOVA and post hoc; p<0.05 was taken to be significant.

Results: The respiratory distress was significantly improved in both steroid groups, as compared to the controls, and the lower Downes scores (p<0.003) and respiratory rates (p<0.012). Duration of respiratory distress (p<|human|>Oxygen therapy (p<|human|>Hospital stay (p<|human|>Mechanical ventilation (p<|human|>Mechanical ventilation (p<|human|>Significant decreases were seen in duration of respiratory distress (p<|human|>Oxygen therapy (p<|human|>Hospital stay (p<|human IV methylprednisolone proved to be more effective than nebulized beclomethasone especially in alleviating respiratory distress (p=0.0012). There was no significant difference in mortality among groups ( p=0.6).

Conclusion: Corticosteroids are useful in MAS, but do not influence mortality. IV methylprednisolone seems to be more effective than the nebulized beclomethasone.