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Title: OUTCOMES OF TERM NEONATES WITH MECONIUM-STAINED AMNIOTIC FLUID
Authors: Anum Pervaiz, Talal Waqar, Muhammad Tariq Nadeem, Iqra Irfan, Muhammad Ali Zia, Adeel Mehmood
Journal: Insights-Journal of Health and Rehabilitation
| Category | From | To |
|---|---|---|
| Y | 2024-10-01 | 2025-12-31 |
Publisher: Health And Research Insights (SMC-Private) Limited
Country: Pakistan
Year: 2024
Volume: 2
Issue: 2
Language: English
DOI: 10.71000/ijhr60
Keywords: NewbornNeonatal sepsisGestational ageBrainRespiratory distress syndromeMeconiumLaborAspiration SyndromeHypoxia-IschemiaInducedMeconium-Stained Amniotic Fluid
Background: Meconium-stained amniotic fluid (MSAF) is a common complication in term pregnancies, occurring in approximately 5-20% of deliveries and often indicating fetal distress. While MSAF can lead to serious neonatal complications, including respiratory distress syndrome (RDS), hypoxic ischemic encephalopathy (HIE), and sepsis, not all cases of MSAF result in adverse outcomes. Identifying factors associated with MSAF is essential to enhance clinical management and improve neonatal outcomes.
Objectives: The primary objective was to determine the frequency of complications associated with MSAF in term neonates. The second objective was to assess the risk of maternal, neonatal, and gestational factors associated with the occurrence of MSAF in term neonates.
Methods: This case-control study was conducted in the Department of Pediatrics, Combined Military Hospital, Kharian, from October 2022 to September 2023. A total of 100 term neonates (50 with MSAF and 50 without) were enrolled. Neonates born between 37 and 42 weeks who experienced a trial of labor were included, while those delivered by elective cesarean section, with major congenital anomalies, or hemorrhagic amniotic fluid were excluded. Data on maternal, neonatal, and gestational characteristics were collected. All neonates were monitored for one month post-birth for any adverse outcomes in both inpatient and outpatient settings.
Results: Complications among neonates with MSAF included HIE in 3 (6.0%), RDS in 6 (12.0%), pneumothorax in 1 (2.0%), persistent pulmonary hypertension in 2 (4.0%), and sepsis in 12 (24.0%). Significant risk factors for MSAF included prolonged active labor over 6 hours (adjusted odds ratio [aOR]: 2.84, 95% confidence interval [CI]: 1.08–7.45, p=0.034), induction of labor (aOR: 4.65, 95% CI: 1.55–13.95, p=0.006), and gestational age at birth greater than 39 weeks (aOR: 4.01, 95% CI: 1.47–10.97, p=0.007).
Conclusion: MSAF is associated with significant neonatal complications, highlighting the need for careful management of risk factors such as prolonged labor, labor induction, and advanced gestational age to reduce the incidence and impact of MSAF.
To determine the frequency of complications associated with meconium-stained amniotic fluid (MSAF) in term neonates and to assess the risk of maternal, neonatal, and gestational factors associated with MSAF.
A case-control study was conducted with 100 term neonates (50 with MSAF and 50 without). Data on maternal, neonatal, and gestational characteristics were collected. Neonates were monitored for one month post-birth for adverse outcomes. Statistical analysis included descriptive statistics, Chi-square/Fisher's exact tests, and binary logistic regression.
graph TD;
A["Enrollment of Term Neonates MSAF vs. Control"] --> B["Data Collection: Maternal, Neonatal, Gestational Characteristics"];
B --> C["Monitoring for Adverse Outcomes - 1 Month Post-Birth"];
C --> D["Statistical Analysis: Descriptive, Chi-square, Logistic Regression"];
D --> E["Identify Significant Risk Factors and Complications"];
E --> F["Conclusion and Implications"];
MSAF is associated with varied severity of staining and an increased likelihood of adverse neonatal outcomes, particularly RDS. While maternal complications like placental abruption were more frequent in cases, they were not statistically significant. Key risk factors identified were prolonged active labor, labor induction, and advanced gestational age, suggesting these factors contribute to meconium passage.
Complications in neonates with MSAF included hypoxic ischemic encephalopathy (HIE) in 6.0%, respiratory distress syndrome (RDS) in 12.0%, pneumothorax in 2.0%, persistent pulmonary hypertension (PPH) in 4.0%, and sepsis in 24.0%. Significant risk factors for MSAF were prolonged active labor (>6 hours), induction of labor, and gestational age at birth >39 weeks. The overall complication rate was significantly higher in the MSAF group (34%) compared to the control group (12%).
Meconium-stained amniotic fluid is linked to significant neonatal complications. Addressing risk factors such as labor induction, prolonged active labor, and advanced gestational age through careful monitoring and management is crucial to reduce MSAF incidence and improve neonatal outcomes.
- Meconium-stained amniotic fluid (MSAF) occurs in approximately 5-20% of deliveries. (Stated in Abstract and Introduction)
- Complications in neonates with MSAF included HIE in 6.0%, RDS in 12.0%, pneumothorax in 2.0%, PPH in 4.0%, and sepsis in 24.0%. (Stated in Results)
- Significant risk factors for MSAF included prolonged active labor over 6 hours (aOR: 2.84), induction of labor (aOR: 4.65), and gestational age at birth greater than 39 weeks (aOR: 4.01). (Stated in Results)
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