Determinants of Meconium-Stained Amniotic Fluid at Hadiya Zone Hospitals, Southern Ethiopia; Unmatched Case-Control Study

Abstract

Background Meconium-stained amniotic fluid (MSAF) refers to an amniotic fluid that is green in color or mixed with meconium. MSAF leads to a serious maternal complication that increases the likelihood of operative delivery and poses a hazard to the fetus or the neonate. This in turn enhances the chances of maternal and neonatal mortality and morbidity. So, the identification of determinants helps to breach this vicious cycle. The current study aimed to assess the determinants of MSAF. Methods An institution-based, unmatched case-control study with a sample size of 363 participants (121 cases and 242 controls) was conducted on mothers who gave birth at Hadiya zone public hospitals between March and April 2020. A proportionate distribution was made to each facility depending on the volume of patients, and cases and control mothers were chosen sequentially. The data was gathered through in-person interviews and secondary data extraction. In multivariable logistic regression, variables with (p < 0.25) in bivariate analysis were included. After multivariable logistic regression was finished, statistical significance was declared at (p < 0.05). Results A total of 121 cases and 242 controls were included in this study Multivariable logistic regression analysis showed that gestational age ≥ 41 week (AOR = 3.44, 95% CI: 1.02–11.63), premature rupture of membrane (AOR = 3.71, 95% CI: 1.98–6.93) obstructed labor (AOR = 2.90, 95% CI: 1.15–7.33) preeclampsia (AOR = 4.16, 95% CI: 1.29–13.35) and non-reassuring fetal heart rate (AOR = 6.75, 95% CI: 3.45–13.19) were significantly associated with MSAF. Conclusion Advanced gestational age, an early membrane rupture, an obstructed labor, preeclampsia, and non-reassuring fetal heart rate all increase the incidence of meconium-stained amniotic fluid in laboring mothers. Making every effort to prevent, identify, and treat those obstetric determinants as early as feasible should be taken into consideration throughout follow-up of pregnancy, labor, and delivery could assist to lower the incidence of MSAF.

Comparison Of Maternal And Perinatal Outcome Of Isolated Borderline Amniotic Fluid Index Versus Normal Amniotic Fluid In Low-Risk Pregnancies At Term

“…There is an increased risk of meconium staining of liquor in postdate pregnancy, pre-eclampsia, prolonged labour, prelabour rupture of membranes, fetal distress, and intrauterine growth restriction. 22 Our findings are supported by the studies of Bajracharya N and Wood SL who also observed no significant increase in meconium staining of amniotic fluid (p=0.216& p=0.23 respectively). 20,21 Vyas A noted a higher rate of passage of meconium in cases of borderline AFI ( 27% versus 11%, p=0.006).…”

The incidence and determinants of the meconium-aspiration syndrome among mothers with meconium-stained amniotic fluid after emergency cesarean section: A prospective cross-sectional study in a specialized hospital, south Ethiopia

“…According to studies, 20%–33% of neonates born with meconium have neurologic and respiratory depression, suggesting chronic exposure to a hypoxic environment ( 4 , 16 , 21 , 22 , 38 , 39 ). Most of the studies associate the stage of labor with the incidence of meconium-stained amniotic fluid ( 37 , 38 , 40 , 41 ), but some studies associate labor abnormalities ( 25 ) with MAS.…”

Perinatal predictors of postpartum depression

“…Meconium is the first substance found in the developing foetus's intestines and constitutes the new-born's first bowel movement. Green, brown, or yellow meconium is possible [52].…”