Utility of Inflammatory Cytokines to Predict the Severity of Meconium Aspiration Syndrome in Newborn

Objective: Respiratory failure caused by the inflammatory response to meconium aspiration is an important known pathophysiological mechanism of meconium aspiration syndrome (MAS).This study investigated the inflammatory cytokines in patients with MAS, the clinical severity of MAS, and the incidence of persistent pulmonary hypertension of the newborn (PPHN) to verity the utility of inflammatory cytokines as predictors of MAS severity.Methods: A prospective study was conducted on 45 patients at the gestational age of 35 weeks or more who were admitted to the neonatal intensive care unit at Dong-A University Hospital due to MAS during the period from November 2018 to February 2021 and agreed to participate.From the serum test performed at admission, the levels of proinflammatory cytokines (tumor necrosis factor-, interleukin [IL]-1, IL-6, IL-12, and interferon-), anti-inflammatory cytokines (IL-4 and IL-10), and related inflammatory cytokines (IL-21 and IL-23) and a complement (C5a), were estimated, and the data were comparatively analyzed with the clinical severity (mild, moderate, severe) and the incidence of PPHN. Results:The clinical severity of the patients was mild in 16 (35.6%),moderate in 16 (35.6%),and severe in 13 (28.9%).PPHN was identified in seven patients (15.6%), and the levels of IL-6 and IL-10 increased significantly with increased clinical severity in PPHN patients. Conclusion:This implied an important role of IL-6 and IL-10 as predictors of early MAS severity.These results show that the clinical severity and development of PPHN can be predicted at an early stage of MAS, thereby improving the prognosis of respiratory and neurological conditions.