G/Silassie Rediet, Gebretsadik Woiynshet, Degefa Nega, Getahun Dinkalem, Kassie Nigus
Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
Schools of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Int J Womens Health. 2022 Sep 16;14:1351-1360. doi: 10.2147/IJWH.S376963. eCollection 2022.
Meconium-stained amniotic fluid (MSAF) refers to an amniotic fluid that is green in color or mixed with meconium. MSAF leads to a serious maternal complication that increases the likelihood of operative delivery and poses a hazard to the fetus or the neonate. This in turn enhances the chances of maternal and neonatal mortality and morbidity. So, the identification of determinants helps to breach this vicious cycle. The current study aimed to assess the determinants of MSAF.
An institution-based, unmatched case-control study with a sample size of 363 participants (121 cases and 242 controls) was conducted on mothers who gave birth at Hadiya zone public hospitals between March and April 2020. A proportionate distribution was made to each facility depending on the volume of patients, and cases and control mothers were chosen sequentially. The data was gathered through in-person interviews and secondary data extraction. In multivariable logistic regression, variables with (p < 0.25) in bivariate analysis were included. After multivariable logistic regression was finished, statistical significance was declared at (p < 0.05).
A total of 121 cases and 242 controls were included in this study Multivariable logistic regression analysis showed that gestational age ≥ 41 week (AOR = 3.44, 95% CI: 1.02-11.63), premature rupture of membrane (AOR = 3.71, 95% CI: 1.98-6.93) obstructed labor (AOR = 2.90, 95% CI: 1.15-7.33) preeclampsia (AOR = 4.16, 95% CI: 1.29-13.35) and non-reassuring fetal heart rate (AOR = 6.75, 95% CI: 3.45-13.19) were significantly associated with MSAF.
Advanced gestational age, an early membrane rupture, an obstructed labor, preeclampsia, and non-reassuring fetal heart rate all increase the incidence of meconium-stained amniotic fluid in laboring mothers. Making every effort to prevent, identify, and treat those obstetric determinants as early as feasible should be taken into consideration throughout follow-up of pregnancy, labor, and delivery could assist to lower the incidence of MSAF.
胎粪污染羊水（MSAF）是指羊水呈绿色或与胎粪混合。MSAF会导致严重的母体并发症，增加手术分娩的可能性，并对胎儿或新生儿构成危害。这反过来又增加了孕产妇和新生儿死亡及发病的几率。因此，确定相关因素有助于打破这一恶性循环。本研究旨在评估MSAF的相关因素。
2020年3月至4月期间，在哈迪亚地区公立医院分娩的母亲中开展了一项基于机构的非匹配病例对照研究，样本量为363名参与者（121例病例和242名对照）。根据各机构的患者数量进行了按比例分配，并依次选择病例组和对照组母亲。数据通过面对面访谈和二次数据提取收集。在多变量逻辑回归中，纳入了双变量分析中p<0.25的变量。多变量逻辑回归完成后，p<0.05时宣布具有统计学意义。
本研究共纳入121例病例和242名对照。多变量逻辑回归分析显示，孕周≥41周（比值比[AOR]=3.44，95%置信区间[CI]：1.02-11.63）、胎膜早破（AOR=3.71，95%CI：1.98-6.93）、产程梗阻（AOR=2.90，95%CI：1.15-7.33）、先兆子痫（AOR=4.16，95%CI：1.29-13.35）和胎儿心率异常（AOR=6.75，95%CI：3.45-13.19）与MSAF显著相关。
孕周增加、胎膜早破、产程梗阻、先兆子痫和胎儿心率异常均会增加分娩母亲胎粪污染羊水的发生率。在整个孕期、分娩期和产褥期的随访过程中，应尽早努力预防、识别和治疗这些产科相关因素，这有助于降低MSAF的发生率。
