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Am J Perinatol 2017; 34(02): 183-190
DOI: 10.1055/s-0036-1585056
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Meconium-Stained Amniotic Fluid and Neonatal Morbidity in Low-Risk Pregnancies at Term: The Effect of Gestational Age

Liran Hiersch
1   Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Eyal Krispin
1   Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Nehama Linder
1   Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Amir Aviram
1   Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Rinat Gabbay-Benziv
1   Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Yariv Yogev
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Eran Ashwal
2   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
› Author Affiliations
Further Information

Publication History

21 March 2016

31 May 2016

Publication Date:
01 July 2016 (online)

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Abstract

Objective To assess the association of gestational age at delivery with perinatal outcome in low-risk term deliveries complicated by meconium-stained amniotic fluid (MSAF).

Methods We 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 370/7 to 386/7 weeks (early term) and 410/7 to 416/7 weeks (late term) were compared with those at 390/7 to 406/7 weeks 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.

Results During 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.

Conclusion Gestational age was associated with specific complications in deliveries complicated by MSAF and otherwise low-risk deliveries.

Keywords

adverse perinatal outcome - gestational age - low-risk pregnancy - meconium-stained amniotic fluid - respiratory morbidity - term
 

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