Exposure to Meconium-Stained Amniotic Fluid and Long-Term Neurological-Related Hospitalizations throughout Childhood

Ron Matalon; Tamar Wainstock; Asnat Walfisch; Eyal Sheiner

doi:10.1055/s-0040-1713863

Exposure to Meconium-Stained Amniotic Fluid and Long-Term Neurological-Related Hospitalizations throughout Childhood

Am J Perinatol. 2021 Dec;38(14):1513-1518. doi: 10.1055/s-0040-1713863. Epub 2020 Jul 3.

Authors

Ron Matalon^{1

2}, Tamar Wainstock³, Asnat Walfisch⁴, Eyal Sheiner²

Affiliations

¹ Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Ben Gurion University of the Negev, Beer-Sheva, Israel.
² Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
³ Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
⁴ Department of Obstetrics and Gynecology, Hadassah Mt. Scopus Medical Center, Jerusalem, Israel.

PMID: 32620023
DOI: 10.1055/s-0040-1713863

Abstract

Objective: This study aimed to investigate the possible impact of meconium-stained amniotic fluid (MSAF) on the occurrence of neurological-related hospitalizations throughout childhood and adolescence.

Study design: In this population-based cohort analysis, all singleton deliveries occurring between 1991 and 2014 at the Soroka University Medical center were included and the long-term neurological-related hospitalizations were compared between children with and without MSAF during their delivery. A Kaplan-Meier survival analysis was constructed for the evaluation of cumulative hospitalization rate due to neurological morbidity over the 18 years of follow-up, and a Cox proportional hazards model was used to study the independent association between MSAF and childhood neurological morbidity while controlling for potential confounders.

Results: During the study period, 243,725 deliveries met the inclusion criteria; 35,897 of the cohort (15%) constituted the exposed group (MSAF), while the rest of the cohort (n = 207,828) constituted the unexposed group (no MSAF). A total of 7,543 hospitalizations due to neurological-related morbidity were documented with a rate of 3.2% (1,152) in children exposed to MSAF as compared with 3.1% (6,391) in the unexposed group (OR 1.1, 95% confidence interval 0.9-1.1, p = 0.149). The survival curve showed a comparable cumulative hospitalization rate in the MSAF-exposed group compared with the unexposed group (log rank p = 0.349). The Cox analysis, controlled for gestational diabetes and hypertension, gestational and maternal ages, demonstrated MSAF exposure not to be an independent risk factor for neurological-related hospitalizations during childhood (adjusted hazard ratio = 1.03, 0.96-1.09).

Conclusion: Fetal exposure to MSAF, at any gestational age, does not appear to be an independent risk factor for later neurological-related hospitalizations throughout childhood and adolescence.

Key points: · MSAF is associated with several short-term complications such as low Apgar scores.. · The long-term implications of MSAF exposure are yet to be clearly defined.. · Fetal exposure to MSAF is not a risk factor for neurological morbidity throughout childhood..

MeSH terms

Adolescent
Amniotic Fluid
Child
Child, Preschool
Cohort Studies
Female
Gestational Age
Hospitalization / statistics & numerical data*
Humans
Incidence
Infant
Infant, Newborn
Kaplan-Meier Estimate
Male
Meconium Aspiration Syndrome / complications*
Nervous System Diseases / epidemiology*
Risk Factors