Adverse Neonatal Outcomes in Relation to Modes of Delivery in Thick Meconium-stained Amniotic Fluid with NICHD Category I Fetal Heart Rate Pattern
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Abstract
Objectives: This work studied the association between adverse neonatal outcomes and modes of delivery in thick meconium-stained amniotic fluid pregnant women with normal fetal heart rate (FHR) patterns and the key factors affecting the adverse neonatal outcomes.
Materials and Methods: This research was a retrospective cohort study. The investigation was conducted by collecting the data of 271 singleton pregnant women who had 37-42 weeks of gestation, were diagnosed with thick meconium-stained amniotic fluid and a normal FHR pattern was determined, according to the National Institute of Child Health and Human Development (NICHD) classification and were admitted to Hatyai Hospital during January 2015 to December 2020. Multivariate analysis was used to determine the association between mode of delivery and neonatal outcomes.
Results: Modes of delivery were not associated with adverse neonatal outcomes. The important factor that was associated with adverse neonatal outcome was oxytocin use > 3 h (adjusted odds ratio (OR) 3.07, p = 0.01). Risk factors of meconium aspiration syndrome (MAS) were the patients who did not receive antenatal care (adjusted OR 31.13, p = 0.04) and the induction of labor (adjusted OR 3.91, p = 0.04). However, increasing the Apgar score could reduce the risk of MAS (adjusted OR 0.61, p < 0.001). A risk factor of neonatal intensive care (NICU) admission was preeclampsia (adjusted OR 6.15, p = 0.02) but increasing the Apgar score at 1 min could reduce the risk of NICU admission (adjusted OR 0.49, p < 0.001).
Conclusion: Modes of delivery were not associated with adverse neonatal outcomes. The significant factor associated with an adverse neonatal outcome was oxytocin use > 3 h.
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