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Kwang-sun Lee - One of the best experts on this subject based on the ideXlab platform.
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Racial disparity in Meconium-stained amniotic fluid and Meconium Aspiration syndrome in the United States, 1989–2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
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racial disparity in Meconium stained amniotic fluid and Meconium Aspiration syndrome in the united states 1989 2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
Sudhir Sriram - One of the best experts on this subject based on the ideXlab platform.
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Racial disparity in Meconium-stained amniotic fluid and Meconium Aspiration syndrome in the United States, 1989–2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
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racial disparity in Meconium stained amniotic fluid and Meconium Aspiration syndrome in the united states 1989 2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
Peter A. Dargaville - One of the best experts on this subject based on the ideXlab platform.
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Refining the method of therapeutic lung lavage in Meconium Aspiration syndrome
Neonatology, 2008Co-Authors: Peter A. Dargaville, Beverley Copnell, David G. Tingay, Michael J. Gordon, John F. Mills, Colin J MorleyAbstract:Background: Therapeutic lung lavage is an emerging treatment for Meconium Aspiration syndrome (MAS), but the ideal fluid volume and lavage technique remain unclear. Objecti
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therapeutic lung lavage in Meconium Aspiration syndrome a preliminary report
Journal of Paediatrics and Child Health, 2007Co-Authors: Peter A. Dargaville, Beverley Copnell, John F. Mills, Peter Loughnan, Peter N Mcdougall, Colin J MorleyAbstract:Aim: To explore the effects of a large volume lung lavage procedure in ventilated infants with Meconium Aspiration syndrome. Methods: Infants with severe Meconium Aspiration requiring high-frequency ventilation underwent lung lavage using dilute bovine surfactant at a phospholipid concentration of 5 mg/mL. Lavage aliquot volumes were increased through the case series, aiming to deliver two aliquots of 15 mL/kg in rapid sequence. Physiological effects of lavage were documented, and comparison was made with a group of infants with Meconium Aspiration requiring high-frequency ventilation, in whom lavage was not performed. Results: Nine episodes of lavage were performed in eight infants at a median age of 23 h (range 8–83 h). Three infants underwent a lavage that was defined as potentially therapeutic (total lavage volume of at least 25 mL/kg administered before 24 h of age). Lavage was not associated with bradycardia or hypotension. Recovery of arterial oxygen saturation to above 80% was achieved within 12 min in all but one infant in whom oxygen saturation was below 80% at the outset. Mean airway pressure was significantly lower in the Therapeutic lavage group compared with non-lavaged infants in the first 48 h, with a trend towards improved oxygenation. Conclusion: Dilute surfactant lavage with aliquots of up to 15 mL/kg appears to be feasible in haemodynamically stable ventilated infants with Meconium Aspiration syndrome, and its efficacy deserves further investigation in a randomised controlled trial.
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surfactant for Meconium Aspiration syndrome in full term infants
Cochrane Database of Systematic Reviews, 2000Co-Authors: Roger F Soll, Peter A. DargavilleAbstract:OBJECTIVES To evaluate the effect of surfactant administration in the treatment of term infants with Meconium Aspiration syndrome. SEARCH STRATEGY Searches were made using Medline (1985 to January 2000) (MeSH terms: pulmonary surfactant and Meconium Aspiration; limits: age groups, newborns; publication type, clinical trials), previous reviews including cross-references, abstracts, conference and symposia proceedings, expert informants, and journal hand searching in the English language. Authors were directly contacted to provide additional data. SELECTION CRITERIA Randomized controlled trials which evaluated the effect of surfactant administration in term infants with Meconium Aspiration syndrome are included in the analysis. DATA COLLECTION AND ANALYSIS Data regarding clinical outcomes including duration of assisted ventilation, duration of supplemental oxygen, pneumothorax, intraventricular hemorrhage (any grade and severe IVH), chronic lung disease, treatment with extracorporeal membrane oxygenation (ECMO), and mortality were excerpted from the reports of the clinical trails by the reviewers. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group. MAIN RESULTS Two randomized controlled trials met inclusion criteria. Findlay (1996) reports a decrease in the risk of pneumothorax (relative risk 0.09, 95% CI 0.01, 1.54, risk difference -0.25, 95% CI -0.45, -0.05). Both Findlay (1996) and Lotze (1998) report a decrease in the number of infants receiving extracorporeal membrane oxygenation. The meta-analysis supports a significant reduction in the risk of requiring extracorporeal membrane oxygenation (typical relative risk 0.64, 95% CI 0.46, 0.91 typical risk difference -0.17, 95% CI -0.30, -0.04). No difference was noted in overall mortality (typical relative risk 1.86 95% CI 0.35, 9.89, typical risk difference 0.02 95% CI -0.03, 0.07). REVIEWER'S CONCLUSIONS In infants with Meconium Aspiration syndrome, surfactant administration may reduce the severity of respiratory illness and decrease the number of infants with progressive respiratory failure requiring support with ECMO. The relative efficacy of surfactant therapy compared to, or in conjunction with, other approaches to treatment including inhaled nitric oxide, liquid ventilation, and high frequency ventilation remains to be tested.
Babak Khoshnood - One of the best experts on this subject based on the ideXlab platform.
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Racial disparity in Meconium-stained amniotic fluid and Meconium Aspiration syndrome in the United States, 1989–2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
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racial disparity in Meconium stained amniotic fluid and Meconium Aspiration syndrome in the united states 1989 2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
Stephen N Wall - One of the best experts on this subject based on the ideXlab platform.
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Racial disparity in Meconium-stained amniotic fluid and Meconium Aspiration syndrome in the United States, 1989–2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.
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racial disparity in Meconium stained amniotic fluid and Meconium Aspiration syndrome in the united states 1989 2000
Obstetrics & Gynecology, 2003Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun LeeAbstract:Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration syndrome, as well as the differences in case fatality from Meconium Aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration syndrome and to estimate the case fatality of Meconium Aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration syndrome but not for Meconium Aspiration syndrome case fatality.