Milani Forozan, Khosousi Leila, Sharami Seyedeh Hajar, Shakiba Maryam, Rasoulian Javid, Attari Seyedeh Maryam, Donyaei-Mobarrez Yalda
Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, Guilan University of Medical Sciences, Rasht, Iran.
J Family Reprod Health. 2023 Dec;17(4):199-204. doi: 10.18502/jfrh.v17i4.14591.
The outcomes and management of low amniotic fluid index (AFI) in pregnancy are controversial. The purpose of this study was to determine the relationship between low AFI and perinatal outcomes.
This prospective study was conducted on 420 uncomplicated singleton pregnant women with a gestational age of over 28 weeks who referred to Al-Zahra Hospital in Rasht (Iran) for routine perinatal care. Pregnant women were divided into 3 groups of 140 patients based on the AFI and were followed up until delivery. Three groups included normal (8<AFI≤25 cm), borderline (5<AFI≤8 cm) and oligohydramnios (AFI≤5cm) AFI.
The three adverse outcomes of respiratory distress, hospitalization in NICU, and length of hospitalization were statistically significantly different between the two groups with normal and borderline AFI and in the borderline group was more than the normal group. Adverse outcomes including; low birth weight (LBW), small for gestational age (SGA), respiratory distress, 1- min APGAR scores<7, hospitalization in NICU and its duration were statistically significantly different between the two groups with normal AFI and oligohydramnios, and it was more in the oligohydramnios group than the normal group. The three adverse outcomes of LBW, SGA and1- min APGAR scores<7 in the two borderline and oligohydramnios groups had statistically significant differences and were more in the oligohydramnios group than the borderline group.
Consideration to the AFI in perinatal care to predict adverse perinatal outcomes and perform necessary interventions to improve these outcomes is necessary.
孕期羊水指数（AFI）低的结局及处理存在争议。本研究旨在确定低AFI与围产期结局之间的关系。
本前瞻性研究对420例孕龄超过28周、转诊至伊朗拉什特市阿尔-扎赫拉医院进行常规围产期护理的无并发症单胎孕妇进行。根据AFI将孕妇分为3组，每组140例患者，随访至分娩。三组包括正常（8＜AFI≤25cm）、临界（5＜AFI≤8cm）和羊水过少（AFI≤5cm）AFI。
呼吸窘迫、入住新生儿重症监护病房（NICU）及住院时间这三项不良结局在AFI正常组与临界组之间差异有统计学意义，且临界组高于正常组。不良结局包括；低出生体重（LBW）、小于胎龄儿（SGA）、呼吸窘迫、1分钟阿氏评分＜7、入住NICU及其持续时间在AFI正常组与羊水过少组之间差异有统计学意义，且羊水过少组高于正常组。LBW、SGA及1分钟阿氏评分＜7这三项不良结局在临界组与羊水过少组之间差异有统计学意义，且羊水过少组高于临界组。
在围产期护理中考虑AFI以预测不良围产期结局并进行必要干预以改善这些结局是必要的。
