Purpose: To analyze postnatal abnormalities in idiopathic polyhydramnios and to estimate whether there was a significant association between the severity of polyhydramnios and postnatally diagnosed abnormalities. Methods: This was a retrospective cohort study of all idiopathic polyhydramnios cases that delivered at our center between 2017 and 2021. Cases were identified as idiopathic after excluding known fetal genetic and/or structural abnormalities (including soft markers for aneuploidies), Rh isoimmunization, fetal anemia, multifetal pregnancies, pregestational (preGDM) or gestational diabetes (GDM), and known infection with TORCH group agents. The primary outcome was the association between polyhydramnios degree and any abnormalities detected after birth. Additional outcomes were the odds of specific groups of abnormalities based on polyhydramnios degree. Results: Outcomes of 242 pregnancies with idiopathic polyhydramnios were analyzed. At least one neurodevelopmental, structural, or genetic abnormality was diagnosed in 16.1% of children born to women with idiopathic polyhydramnios. Moderate and severe polyhydramnios are significantly associated with at least one abnormality diagnosed after birth (45.9%, and 41.6%, respectively, p<0.05). Neurodevelopmental disorders were the most frequent abnormality (8.2%), followed by genetic abnormalities (2.4%), gastrointestinal abnormalities (2%) and nocturnal enuresis (2%). Odds of genetic abnormalities, neurodevelopmental disorders and nocturnal enuresis in moderate polyhydramnios were significantly higher (aOR=5.5, 95%CI 1.01-30.2; aOR: 8.9, 95% CI 2.7-23.7 and OR: 8.9, 95% CI 1.4-55.5, respectively). Gastrointestinal anomalies were significantly associated with severe polyhydramnios, as expected (OR: 15.4, 95% CI 2.4-97.5). Conclusion: Postnatally detected abnormalities are associated with moderate and severe idiopathic polyhydramnios. Particularly high risks include neurodevelopmental disorders, genetic abnormalities, gastrointestinal atresias and nocturnal enuresis.
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