title: Effect of antepartum meconium staining on perinatal and neonatal outcomes among pregnancies with gastroschisis.
abstract: OBJECTIVE
  To investigate the association between meconium staining and perinatal and neonatal outcomes in pregnancies with gastroschisis.
  
  
  METHODS
  Retrospective analysis of infants with prenatally diagnosed gastroschisis born in two academic medical centers between 2008 and 2013. Neonatal outcomes of deliveries with and without meconium staining were compared. Primary outcome was defined as any of the following: neonatal sepsis, prolonged mechanical ventilation, bowel atresia or death. Secondary outcomes were preterm delivery, preterm-premature rupture of membranes (PPROM) and prolonged hospital length of stay.
  
  
  RESULTS
  One hundred and eight infants with gastroschisis were included of which 56 (52%) had meconium staining at delivery. Infants with meconium staining had a lower gestational age at delivery (36.3 (±1.4) versus 37.0 (±1.2) weeks, p = 0.007), and a higher rate of PPROM (25% versus 8%, p = 0.03) than infants without meconium. Meconium staining was not significantly associated with the primary composite outcome or with any of its components. After adjustments, meconium staining remained significantly associated with preterm delivery at <36 weeks [odds ratio OR = 4.0, 95% confidence intervals (CI): 1.5-11.4] and PPROM (OR = 3.8, 95%CI: 1.2-14.5).
  
  
  CONCLUSIONS
  Among infants with gastroschisis, meconium staining was associated with prematurity and PPROM. No significant increase in other adverse neonatal outcomes was seen among infants with meconium staining, suggesting a limited prognostic value of this finding.
authors.affiliation: a Department of Obstetrics & Gynecology , Stanford University School of Medicine , Stanford , CA , USA .
authors.forename: Anna I
authors.initials: AI
authors.lastname: Girsen
authors.affiliation: b Division of Neonatal and Developmental Medicine , Department of Pediatrics, Stanford University School of Medicine , Stanford , CA , USA .
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Wallenstein
authors.affiliation: c Pediatrix Medical Group , San Jose , CA , USA .|d The Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford , Palo Alto , CA , USA .
authors.forename: Alexis S
authors.initials: AS
authors.lastname: Davis
authors.affiliation: b Division of Neonatal and Developmental Medicine , Department of Pediatrics, Stanford University School of Medicine , Stanford , CA , USA .|d The Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford , Palo Alto , CA , USA .
authors.forename: Susan R
authors.initials: SR
authors.lastname: Hintz
authors.affiliation: e Department of Obstetrics and Gynecology , Loma Linda University School of Medicine , Loma Linda , CA , USA , and.
authors.forename: Arti K
authors.initials: AK
authors.lastname: Desai
authors.affiliation: e Department of Obstetrics and Gynecology , Loma Linda University School of Medicine , Loma Linda , CA , USA , and.
authors.forename: Trina
authors.initials: T
authors.lastname: Mansour
authors.affiliation: f Division of Neonatology , Department of Pediatrics, Loma Linda University School of Medicine , Loma Linda , CA , USA.
authors.forename: T Allen
authors.initials: TA
authors.lastname: Merritt
authors.affiliation: a Department of Obstetrics & Gynecology , Stanford University School of Medicine , Stanford , CA , USA .|d The Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford , Palo Alto , CA , USA .
authors.forename: Maurice L
authors.initials: ML
authors.lastname: Druzin
authors.affiliation: e Department of Obstetrics and Gynecology , Loma Linda University School of Medicine , Loma Linda , CA , USA , and.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Oshiro
authors.affiliation: a Department of Obstetrics & Gynecology , Stanford University School of Medicine , Stanford , CA , USA .|d The Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford , Palo Alto , CA , USA .
authors.forename: Yair J
authors.initials: YJ
authors.lastname: Blumenfeld
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D020139:Gastroschisis / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology*; D007234:Infant, Premature; D007902:Length of Stay; D008470:Meconium; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013194:Staining and Labeling
keywords: Gastroschisis; meconium; neonatal; outcome; prematurity