Risk Factors Associated with Meconium-Stained Amniotic Fluid and Neonatal Outcomes

Abstract

Introduction: Meconium-stained amniotic fluid (MSAF) is a common complication in term and post-term pregnancies and may indicate fetal distress, increasing the risk of meconium aspiration syndrome (MAS) and other neonatal complications. This study aims to evaluate the risk factors for meconium-stained liquor and assess the outcomes of neonates born with meconium-stained amniotic fluid.

Methodology: This observational study was conducted over 12 months at Patna Medical College and Hospital, involving 200 pregnant women with MSAF. Maternal data were collected, including age, parity, gestational age, and pregnancy complications. Neonatal outcomes, such as Apgar scores, NICU admissions, and the incidence of MAS, were recorded. Statistical analysis was performed using chi-square tests and logistic regression, with a significance level set at p<0.05.

Results: Of the 200 participants, 40% of neonates exposed to thick meconium had Apgar scores below 7 at 1 minute, and 25% required NICU admission. MAS occurred in 20% of cases with thick meconium, compared to 3% in those with thin meconium. Neonatal death was observed in 5% of thick meconium cases. Additionally, cesarean sections were associated with poorer neonatal outcomes, including lower Apgar scores and higher NICU admission rates, compared to vaginal deliveries.

Conclusion: Thick meconium-stained amniotic fluid is associated with significantly worse neonatal outcomes, including higher rates of MAS, NICU admissions, and neonatal deaths. Cesarean sections were linked to poorer outcomes compared to vaginal deliveries. Early detection and timely management of pregnancies complicated by meconium-stained liquor are crucial to improving neonatal outcomes.

Recommendation: Vaginal delivery should be considered when feasible, and close monitoring of neonates born through MSAF is essential. Further studies are recommended to refine management strategies for reducing complications associated with thick meconium-stained liquor.

Keywords: Meconium-Stained Amniotic Fluid, Neonatal Outcomes, Meconium Aspiration Syndrome, Cesarean Delivery, Vaginal Delivery.