Published in PLOS One on 2026-04-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Jabir Aman, Bikila Balis, Naol Oda, Dawit Tamiru, Tadesse Gure Eticha, Dawit Firdisa, Aboma Motuma
Source: PLOS One • DOI 10.1371/journal.pone.0347861
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Meconium aspiration syndrome is a life-threatening respiratory disease affecting around 5% of neonates worldwide. Although several studies have been conducted in developed countries, data on meconium aspiration syndrome and its associated factors remain limited in low-resource settings, including Ethiopia. Therefore, this study aimed to determine the meconium aspiration syndrome and associated factors among neonates admitted to the neonatal intensive care unit at public hospitals in Harari region, Eastern Ethiopia.
A retrospective hospital-based cross-sectional study design was conducted among all neonates admitted from January 1 to December 30, 2023 and data were extracted from patient charts during April 1–30, 2025. A simple random sampling technique was employed to select 417 charts of neonates admitted to the neonatal intensive care unit. The data were collected by a data extraction checklist via Kobo Toolbox. Descriptive statistics and binary logistic regression were used in SPSS version 25 (IBM Corp., Armonk, NY, USA) for the analysis. Adjusted odds ratios with 95% confidence intervals were used to declare statistical significance at a p-value ≤ 0.05.
The prevalence of meconium aspiration syndrome among neonates admitted to the neonatal intensive care unit was 24.2% [95% CI, 20.2–28.6]. Factors significantly associated with meconium aspiration syndrome were post-term gestation [AOR = 9.05, 95% CI 2.38–34.41], antepartum hemorrhage [AOR = 3.34, 95% CI 1.31–8.60], prolonged labor [AOR = 3.06, 95% CI 1.27–7.36], premature rupture of membranes [AOR = 3.65, 95% CI 1.28–10.45], low Apgar scores at 5th minute [AOR = 11.27, 95% CI 3.44–36.92] and intrapartum thick meconium passage [AOR = 5.98, 95% CI 2.6–13.6].
These findings indicate a high prevalence of meconium aspiration syndrome, and to reduce its impact, targeted clinical interventions should be implemented. Pregnancies reaching 42 weeks of gestation, prolonged labor, and high-risk conditions such as antepartum hemorrhage, premature rupture of membranes, or the presence of thick meconium are important factors to consider. Careful monitoring and appropriate management may be warranted in these cases.
Introduction
Meconium-stained amniotic fluid (MSAF) is considered an alarming sign of possible fetal distress linked with an adverse perinatal outcome [1]. Passage of meconium in newborns is a normal developmental event, typically occurring within the first 24–48 hours after birth [2].
Globally, meconium aspiration syndrome (MAS) is a life-threatening respiratory disease occurring when neonates aspirate meconium-stained amniotic fluid near or around birth with varying severity [3]. An average of 8% to 25% of live birth neonates with meconium-stained amniotic fluid (MSAF) have delivery complications and from these around 5% of them develop MAS with a 50% chance of needing mechanical ventilation [4]. Each year, 2.6 million neonates die worldwide, with three-fourths of these deaths occurring in the first week [5,6]. The issue of neonatal mortality and morbidity is a priority of the sustainable development goals (SDG) with the goal of lowering neonatal fatalities to less than 12 deaths per 1000 live births by 2030 [7]. Around 11 million lives would be saved if all nations in the world met the SDGs’ goal of decreasing under-five fatalities, particularly newborn deaths, with more than half of those saved in Sub-Saharan Africa [8,9]. Ethiopia has one of the worst rates of newborn mortality in the world; MAS accounts for a significant portion of these deaths, with the early neonatal period accounting for approximately 80% of all neonatal deaths [10,11].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Jabir Aman, Bikila Balis, Naol Oda, Dawit Tamiru, Tadesse Gure Eticha, Dawit Firdisa, Aboma Motuma. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
- Evidence brief: Adverse neonatal outcomes and associated factors among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A facility-based retrospective cross-sectional study
- Evidence brief: Neonatal survival and mortality predictors among low-birth-weight neonates: A Retrospective cohort study from Suhul Hospital, northern Ethiopia
