Exposure to Meconium-Stained Amniotic Fluid and Long-Term Neurological-Related Hospitalizations throughout Childhood

Ron Matalon; Tamar Wainstock; Asnat Walfisch; Eyal Sheiner

doi:10.1055/s-0040-1713863

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2021; 38(14): 1513-1518
DOI: 10.1055/s-0040-1713863

Original Article

Exposure to Meconium-Stained Amniotic Fluid and Long-Term Neurological-Related Hospitalizations throughout Childhood

Ron Matalon

¹Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Ben Gurion University of the Negev, Beer-Sheva, Israel

²Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

,

Tamar Wainstock

³Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel

,

Asnat Walfisch

⁴Department of Obstetrics and Gynecology, Hadassah Mt. Scopus Medical Center, Jerusalem, Israel

,

Eyal Sheiner

²Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

› Institutsangaben

Abstract

Objective This study aimed to investigate the possible impact of meconium-stained amniotic fluid (MSAF) on the occurrence of neurological-related hospitalizations throughout childhood and adolescence.

Study Design In this population-based cohort analysis, all singleton deliveries occurring between 1991 and 2014 at the Soroka University Medical center were included and the long-term neurological-related hospitalizations were compared between children with and without MSAF during their delivery. A Kaplan-Meier survival analysis was constructed for the evaluation of cumulative hospitalization rate due to neurological morbidity over the 18 years of follow-up, and a Cox proportional hazards model was used to study the independent association between MSAF and childhood neurological morbidity while controlling for potential confounders.

Results During the study period, 243,725 deliveries met the inclusion criteria; 35,897 of the cohort (15%) constituted the exposed group (MSAF), while the rest of the cohort (n = 207,828) constituted the unexposed group (no MSAF). A total of 7,543 hospitalizations due to neurological-related morbidity were documented with a rate of 3.2% (1,152) in children exposed to MSAF as compared with 3.1% (6,391) in the unexposed group (OR 1.1, 95% confidence interval 0.9–1.1, p = 0.149). The survival curve showed a comparable cumulative hospitalization rate in the MSAF-exposed group compared with the unexposed group (log rank p = 0.349). The Cox analysis, controlled for gestational diabetes and hypertension, gestational and maternal ages, demonstrated MSAF exposure not to be an independent risk factor for neurological-related hospitalizations during childhood (adjusted hazard ratio = 1.03, 0.96–1.09).

Conclusion Fetal exposure to MSAF, at any gestational age, does not appear to be an independent risk factor for later neurological-related hospitalizations throughout childhood and adolescence.

Key Points

MSAF is associated with several short-term complications such as low Apgar scores.
The long-term implications of MSAF exposure are yet to be clearly defined.
Fetal exposure to MSAF is not a risk factor for neurological morbidity throughout childhood.

Keywords

meconium-stained amniotic fluid - long-term outcome - neurological morbidity

Volltext

Referenzen

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