Schreiber Hanoch, Shilony Adi, Amrami Reut Batia, Cohen Gal, Markovitch Ofer, Biron-Shental Tal, Bauer-Rusek Sofia, Arnon Shmuel, Kovo Michal
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428163, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel.
Children (Basel). 2023 Jan 26;10(2):215. doi: 10.3390/children10020215.
Several reports regarding the effects of thin meconium on maternal and neonatal outcomes are contradictory. This study evaluated the risk factors and obstetrical outcomes during deliveries complicated with thin meconium. This retrospective cohort study included all women with a singleton pregnancy, who underwent trial of labor >24 weeks of gestation, in a single tertiary center, over a six-year period. Obstetrical, delivery, and neonatal outcomes were compared between deliveries with thin meconium (thin meconium group) to deliveries with clear amniotic fluid (control group). Included in the study were 31,536 deliveries. Among them 1946 (6.2%) were in the thin meconium group and 29,590 (93.8%) were controls. Meconium aspiration syndrome was diagnosed in eight neonates in the thin meconium group and in none of the controls (0.41%, < 0.001). In multivariate logistic regression analysis, the following adverse outcomes were found to be independently associated with increased odds ratio (OR) for thin meconium: intrapartum fever (OR 1.37, 95% CI 1.1-1.7), instrumental delivery (OR 1.26, 95% CI 1.09-1.46), cesarean delivery for non-reassuring fetal heart rate (OR 2.0, 95% CI 1.68-2.46), and respiratory distress requiring mechanical ventilation (OR 2.06, 95% CI 1.19-3.56). Thin meconium was associated with adverse obstetrical, delivery, and neonatal outcomes that should receive extra neonatal care and alert the pediatrician.
关于稀薄胎粪对孕产妇和新生儿结局影响的几份报告相互矛盾。本研究评估了分娩过程中合并稀薄胎粪时的危险因素及产科结局。这项回顾性队列研究纳入了在一个单一的三级中心，在六年期间内所有单胎妊娠、妊娠>24周且接受引产的妇女。将稀薄胎粪分娩（稀薄胎粪组）与羊水清的分娩（对照组）的产科、分娩及新生儿结局进行比较。该研究共纳入31536例分娩。其中1946例（6.2%）为稀薄胎粪组，29590例（93.8%）为对照组。稀薄胎粪组有8例新生儿被诊断为胎粪吸入综合征，而对照组无一例（0.41%，<0.001）。在多因素逻辑回归分析中，发现以下不良结局与稀薄胎粪的比值比（OR）增加独立相关：产时发热（OR 1.37，95%CI 1.1 - 1.7）、器械助产（OR 1.26，95%CI 1.09 - 1.46）、因胎儿心率异常行剖宫产（OR 2.0，95%CI 1.68 - 2.46）以及需要机械通气的呼吸窘迫（OR 2.06，95%CI 1.19 - 3.56）。稀薄胎粪与不良的产科、分娩及新生儿结局相关，这些情况应给予额外的新生儿护理并提醒儿科医生注意。
