Prediction of adverse neonatal outcome among newborns born through meconium-stained amniotic fluid

Abstract

Objective: To study maternal and intrapartum factors associated with adverse neonatal outcome in deliveries complicated by meconium-stained amniotic fluid (MSAF).

Methods: A retrospective cohort study of all women with singleton gestations undergoing trial of labor with MSAF during 2011-2020. Deliveries with adverse neonatal outcome were compared with deliveries without.

Results: Overall, 11 329 were included; 376 (3.3%) neonates were diagnosed with adverse neonatal outcomes. Multivariable regression analysis underlined the following factors as independently associated with composite adverse neonatal outcome: pregestational diabetes (odds ratio [OR] 3.21, 95% confidence interval [CI] 1.09-9.43, P = 0.031), polyhydramnios (OR 2.14, 95% CI 1.33-3.44, P = 0.002), fever (OR 2.52, 95% CI 1.67-3.80, P < 0.001), and amnioinfusion (OR 1.73, 95% CI 1.24-2.2438, P = 0.003). When 0, 1, 2, and 3 of the independent risk factors identified were present, the rates of adverse neonatal outcome were 2.9%, 5.5%, 10.0%, and 100%, respectively.

Conclusion: The current study's results suggest that special attention should be payed to deliveries complicated by MSAF and with any of the following factors-polyhydramnios, intrapartum fever, amnioinfusion, and pregestational diabetes.

Keywords: adverse outcome; amnioinfusion; intrapartum fever; meconium; meconium aspiration syndrome.