The Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Int J Gynaecol Obstet. 2021 Sep;154(3):515-520. doi: 10.1002/ijgo.13592. Epub 2021 Feb 11.
To study maternal and intrapartum factors associated with adverse neonatal outcome in deliveries complicated by meconium-stained amniotic fluid (MSAF).
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.
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.
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.
研究与胎粪污染羊水（MSAF）相关的分娩时母婴因素与不良新生儿结局的关系。
对 2011 年至 2020 年期间所有患有 MSAF 并尝试阴道分娩的单胎妊娠女性进行回顾性队列研究。将有不良新生儿结局的分娩与无不良新生儿结局的分娩进行比较。
共有 11 329 例患者纳入研究，其中 376 例（3.3%）新生儿被诊断为不良新生儿结局。多变量回归分析强调了以下因素与复合不良新生儿结局独立相关：孕前糖尿病（比值比 [OR] 3.21，95%置信区间 [CI] 1.09-9.43，P=0.031）、羊水过多（OR 2.14，95% CI 1.33-3.44，P=0.002）、发热（OR 2.52，95% CI 1.67-3.80，P<0.001）和羊膜腔灌注（OR 1.73，95% CI 1.24-2.2438，P=0.003）。当存在独立危险因素中的 0、1、2 和 3 个时，不良新生儿结局的发生率分别为 2.9%、5.5%、10.0%和 100%。
本研究结果表明，对于 MSAF 合并羊水过多、产时发热、羊膜腔灌注和孕前糖尿病的患者，应特别注意。
