Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Eur J Pediatr. 2022 Aug;181(8):3153-3162. doi: 10.1007/s00431-022-04530-8. Epub 2022 Jul 19.
We aimed to evaluate the association between meconium-stained amniotic fluid during labor and offspring's childhood wheezing. This study analyzed the data of participants enrolled in the Japan Environment and Children's Study, a nationwide prospective birth cohort study, between 2011 and 2014. Data of women with singleton live births between 22 and 40 weeks' gestation were analyzed. Participants were categorized into two groups according to the presence or absence of meconium-stained amniotic fluid. The primary outcome measure was the offspring's childhood wheezing up to 3 years of age. A logistic regression model was used to calculate the adjusted odds ratio for childhood wheezing in children of women with meconium-stained amniotic fluid, considering those without meconium-stained amniotic fluid as a reference, taking into account the potential confounding factors affecting the incidence of wheezing. We analyzed data from 61,991 participants: 1796 (2.9%) participants had meconium-stained amniotic fluid during labor and 18,919 (30.5%) of the offspring had childhood wheezing. The adjusted odds ratios for the offspring's childhood wheezing were 0.89 (95% confidence interval, 0.79-0.99) in total participants, 0.87 (95% confidence interval, 0.78-0.97) in term births, and 2.00 (95% confidence interval, 0.98-4.09) in preterm births.
This study revealed a decreased incidence of childhood wheezing among the children of women with meconium-stained amniotic fluid in term births. By yet unknown mechanisms, meconium-stained amniotic fluid was associated with a decreased incidence of childhood wheezing in the offspring. Further studies are required to clarify the mechanism of one's own meconium in affecting their health condition.
• Meconium-stained amniotic fluid during labor is associated with several adverse perinatal outcomes, and meconium aspiration syndrome is associated with offspring's childhood asthma and wheezing. • Meconium-stained amniotic fluid during labor could be an independent protective factor for the offspring's dermatitis and skin rash.
• Whole cases with meconium-stained amniotic fluid during labor were associated with a decreased incidence of offspring's childhood wheezing up to 3 years of age. • This study may shed light on the effects of simple meconium-stained amniotic fluid on offspring's childhood health.
评估分娩时胎粪污染羊水与后代儿童喘息之间的关联。本研究分析了 2011 年至 2014 年间参加日本环境与儿童研究的参与者的数据，这是一项全国性的前瞻性出生队列研究。分析了 22 至 40 周妊娠期间单胎活产妇女的数据。根据是否存在胎粪污染羊水，将参与者分为两组。主要结局测量指标为 3 岁以下儿童的喘息。采用 logistic 回归模型，在考虑羊水无胎粪污染作为参考的情况下，计算胎粪污染羊水的女性后代儿童喘息的校正比值比，同时考虑影响喘息发生率的潜在混杂因素。我们分析了 61991 名参与者的数据：1796 名（2.9%）参与者在分娩时羊水胎粪污染，18919 名（30.5%）后代儿童喘息。在所有参与者中，儿童喘息的校正比值比为 0.89（95%置信区间，0.79-0.99），足月产为 0.87（95%置信区间，0.78-0.97），早产为 2.00（95%置信区间，0.98-4.09）。
本研究显示，在足月产中，羊水胎粪污染的女性后代儿童喘息发生率降低。胎粪污染羊水通过未知机制与后代儿童喘息发生率降低相关。需要进一步的研究来阐明胎粪本身影响其健康状况的机制。
分娩时胎粪污染羊水与多种围产期不良结局相关，胎粪吸入综合征与后代儿童哮喘和喘息有关。
分娩时胎粪污染羊水可能是儿童特应性皮炎和皮疹的独立保护因素。
所有胎粪污染羊水的病例与后代儿童 3 岁以下喘息发生率降低相关。
本研究可能揭示了简单的胎粪污染羊水对后代儿童健康的影响。
