title: Meconium-stained amniotic fluid is associated with puerperal infections.
abstract: OBJECTIVE
  The purpose of this study was to determine whether meconium-stained amniotic fluid is associated with puerperal infection and whether the quality of the meconium is further associated with this risk.
  
  
  METHODS
  We designed a retrospective cohort study of all deliveries beyond 37 weeks gestational age from 1992 to 2002 at a single community hospital. Data were collected on rates of chorioamnionitis, endomyometritis, quality of amniotic fluid, and length of labor and analyzed with bivariate and multivariate analyses.
  
  
  RESULTS
  We found that, among the 43,200 women who were delivered at term, 18.9% of the women had meconium staining (8.8% thin, 5.5% moderate, 4.6% thick). Compared with deliveries with clear amniotic fluid, those with meconium-stained amniotic fluid had higher rates of chorioamnionitis (2.3% vs 4.1%, P<.001) and endomyometritis (1.0% vs 1.7%, P<.001). Further, the severity of meconium staining was associated with increased rates of infection.
  
  
  CONCLUSIONS
  We found that the presence and severity of meconium-stained amniotic fluid is associated with puerperal infection even when being controlled for confounders.
authors.affiliation: Department of Obstetrics and Gynecology, Kaiser Permanente, San Francisco, CA, USA.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Tran
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Musci
mesh_terms: D000328:Adult; D000653:Amniotic Fluid; D000704:Analysis of Variance; D001724:Birth Weight; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000453:epidemiology; D036861:Delivery, Obstetric; D004522:Educational Status; D004716:Endometritis / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D008470:Meconium; D007744:Obstetric Labor Complications / Q000453:epidemiology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011645:Puerperal Infection / Q000453:epidemiology*