title: Meconium-Stained Amniotic Fluid and Neonatal Morbidity in Low-Risk Pregnancies at Term: The Effect of Gestational Age.
abstract: ObjectiveTo assess the association of gestational age at delivery with perinatal outcome in low-risk term deliveries complicated by meconium-stained amniotic fluid (MSAF).MethodsWe retrospectively analyzed all singleton deliveries that underwent a trial of labor in a single hospital (2007-2013). Exclusion criteria included pregnancy-related complications (e.g., hypertensive disorders, diabetes, oligohydramnios, and fetal anomalies). First, only deliveries with MSAF were analyzed. Perinatal outcome of deliveries at 370/7to 386/7weeks (early term) and 410/7to 416/7weeks (late term) were compared with those at 390/7to 406/7weeks of gestation (full term). Additionally, a gestational age based comparison was made between the risk for neonatal respiratory morbidity in deliveries with clear amniotic fluid and MSAF.ResultsDuring the study period, 28,248 deliveries were considered as low risk. Of them, 3,399 (12.0%) were diagnosed with MSAF and were divided to full term (n= 2,413), early term (n= 405), and late term (n= 581). In multivariate analysis, MSAF at early term was associated with neonatal jaundice, need for phototherapy, and neonatal sepsis. In a gestational age based stratification, when comparing between deliveries with clear amniotic fluid and those with MSAF, late term had the highest odds (4.2 vs. 0.5%;p< 0.001) for neonatal respiratory morbidity.ConclusionGestational age was associated with specific complications in deliveries complicated by MSAF and otherwise low-risk deliveries.
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Krispin
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Nehama
authors.initials: N
authors.lastname: Linder
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
mesh_terms: D000328:Adult; D000653:Amniotic Fluid; D001034:Apgar Score; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007557:Israel / Q000453:epidemiology; D007567:Jaundice, Neonatal / Q000453:epidemiology* / Q000628:therapy; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D010343:Patient Admission; D010789:Phototherapy / Q000706:statistics & numerical data; D012120:Respiration Disorders / Q000453:epidemiology* / Q000628:therapy; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*; D059246:Tachypnea / Q000453:epidemiology; D047929:Term Birth; D055815:Young Adult