Risk factors and clinical outcome of meconium-stained amniotic fluid in preterm infants

Corresponding author: tianchangjun, tcjun8183@163.com

DOI: 10.12201/bmr.202502.00007

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  Abstract: Objective To investigate and analyze the risk factors for meconium-stained amniotic fluid(MSAF) in preterm infants and the clinical outcome and prognosis of preterm infants. Methods Preterm infants with gestational age <37 weeks delivered in our hospital from January 2022 to December 2023 were used as the study subjects, and they were grouped according to the presence or absence of meconium-stained amniotic fluid; 31 cases with meconium-stained amniotic fluid were in the MSAF group, and 31 cases of preterm infants hospitalized during the same period without meconium-stained amniotic fluid were randomly paired in the ratio of 1:1 to select 31 cases of preterm infants with gestational age-weight matching as the non-MSAF group. Retrospective collection and analysis of pregnancy and perinatal conditions of mothers of preterm infants in the two groups, comparing the differences of related factors between the two groups of children; Logistic regression analysis of risk factors related to MSAF in preterm infants; comparing the complications and clinical outcomes of preterm infants in the two groups. Results A total of 387 preterm infants with gestational age <37 weeks were collected during the study period, including 31 preterm infants with comorbid MSAF, and the prevalence of MSAF in preterm infants was 8.0%. The MSAF group had a higher incidence of advanced maternal age, premature rupture of membranes >18 hours, antepartum fever, and cholestasis during pregnancy than the non-MSAF group. Logistic regression analysis suggested that combined cholestasis during pregnancy and WBC count ≥30×109/L within 6 h after birth increased the incidence of MSAF in preterm infants. There was no statistically significant difference in the results of postnatal umbilical artery blood gas analysis between the two groups of preterm infants. The proportion of leukocyte count ≥30×10E9/L, ultrasensitive C-reactive protein >0.8 mg/L, and interleukin 6 >6 pg/L in the MSAF group was higher than that of the non-MSAF group in the 6 hours after birth. The MSAF group had a higher incidence of intrauterine infectious pneumonia, feeding intolerance, and necrotizing small bowel colitis in neonates than the non-MSAF group. Conclusions Advanced maternal age, intrauterine infections, and combined intrahepatic cholestasis during pregnancy may be the major risk factors for MSAF in preterm infants.MSAF preterm infants have a higher prevalence of intrauterine infectious pneumonitis, feeding intolerance, and necrotizing small bowel colitis in newborns, as well as longer hospital stays.

  Key words: Preterm infants; Meconium-stained amniotic fluid; Risk factors; Complications

  Submit time: 8 February 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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