Influencing factors of neonatal adverse outcomes with meconium-stained amniotic fluid
Objective To explore the impact of meconium-stained amniotic fluid on short-term outcomes in newborns delivered vaginally by primigravid women and analyze the influencing factors associated with neonatal adverse outcomes.Methods A total of 3 113 primiparas delivered vaginally at term in singleton cephalic position in Guangzhou Women and Children's Medical Center of Guangzhou Medical University from February 1,2022 to January 31,2023 were included.The subjects were classified into two groups using propensity score matching:a normal amniotic fluid group(535 cases)and a meconium-stained amniotic fluid group(535 cases).In the normal amniotic fluid group,the maternal age was(31.12±4.17)years old,the gestational week was(39.67±0.86)weeks,and the body mass index was(25.88±2.91)kg/m2.In the meconium-stained amniotic fluid group,the maternal age was(29.61±3.10)years old,the gestational week was(39.60±0.84)weeks,and the body mass index was(25.69±2.77)kg/m2.According to whether the adverse outcomes were present,the newborns with meconium-stained amniotic fluid were further divided into a non-adverse outcome group(423 cases)and an adverse outcome group(268 cases).Univariate analysis was performed to analyze the clinical baseline characteristics,and multivariate logistic regression analysis were used to further explore the influencing factors of neonatal adverse outcomes.Results Compared with the normal amniotic fluid group,the meconium-stained amniotic fluid group had a higher rate of admission to neonatal intensive care unit[6.2％(33/535)vs.1.1％(6/535)](x2=19.399,P＜0.001).The risk of neonatal adverse outcomes with meconium-stained amniotic fluid was associated with category Ⅱ/Ⅲ cardiocography,prolonged first stage of labor,and grade Ⅲ meconium staining(OR=4.536,95％CI 2.818-7.301,P＜0.001;OR=1.001,95％CI1.000-1.002,P=0.014;OR=3.756,95％CI 2.112-6.680,P＜0.001).Conclusions Meconium-stained amniotic fluid in primiparas increases the rate of admission to neonatal intensive care unit for newborns;categoryⅡ/Ⅲ cardiocography,grade Ⅲ meconium staining in amniotic fluid,and prolonged first stage of labor are associated with increased risk of short-term adverse outcomes in newborns.
万方数据
维普
