Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections

Siriwachirachai, Thitiporn; Sangkomkamhang, Ussanee S; Lumbiganon, Pisake; Laopaiboon, Malinee

doi:10.1002/14651858.cd007772.pub3

Cited by 33 publications

(17 citation statements)

References 36 publications

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“…Nevertheless, antibiotic prophylaxis in cases of MSAF was not found to alter that risk. 34 It may imply that the higher rates of neonatal sepsis were not caused by intrauterine infection, but rather the result of an increased susceptibility of the meconium-exposed newborn for infection.…”

Section: Discussionmentioning

confidence: 99%

Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term

et al. 2015

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“…There are various theories as to which pathophysiologic pathway explains the association between MSAF exposure and the aforementioned adverse outcomes. The association between infectious processes (chorioamnionitis, neonatal sepsis) and MSAF exposure has raised a question regarding the presence of bacterial content in the meconium. While for many years the "sterile womb" hypothesis has been accepted, recent studies have attempted to find evidence that in utero colonization occurs.…”

Section: Introductionmentioning

confidence: 99%

Meconium‐stained amniotic fluid exposure is associated with a lower incidence of offspring long‐term infectious morbidity

Levy

Walfisch

Wainstock

et al. 2019

American J Rep Immunol

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Objective Meconium‐stained amniotic fluid (MSAF) is a well‐established risk factor for immediate adverse neonatal outcomes and was recently suggested to be associated with microbial invasion of the amniotic cavity. We aimed to determine whether MSAF exposure during labor carries a longer lasting impact on pediatric infectious morbidity. Study design A population‐based cohort analysis was performed including all singleton deliveries occurring between 1991 and 2014 at a single tertiary medical center. Exposure was defined as the presence of MSAF during labor. Hospitalizations of the offspring up to the age of 18 years involving infectious diseases were evaluated. A Kaplan‐Meier survival curve was used to compare cumulative morbidity and a Cox regression model to control for confounders. Results During the study period, 243 725 deliveries met the inclusion criteria. Of them, 35 897 (14.7%) involved MSAF. Rate of infectious‐related hospitalizations of the offspring was significantly lower in children exposed to MSAF as compared with the unexposed group (10.8% vs 11.1%, P < 0.05). Specifically, hospitalizations involving respiratory infections were significantly less common among the MSAF group (5.1% vs 5.6%, P < 0.001). The survival curve demonstrated significantly lower cumulative total infectious morbidity rates in the MSAF‐exposed group (log rank P < 0.001). In the Cox model, controlled for maternal age, diabetes, hypertension, mode of delivery, and gestational age, exposed children exhibited lower rates of long‐term childhood infectious morbidity (adjusted HR 0.96, 95% CI 0.92‐0.99, P < 0.001). Conclusion Fetal exposure to MSAF during labor and delivery appears to be associated with lower rates of long‐term infectious‐related hospitalizations in the offspring.

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“…In utero, passage of meconium is relatively common occurring to 7-22% of all term deliveries. 1 Meconium passage is rare before 34 weeks of gestation and incidence increases steadily beyond 37 weeks of gestation. 2 The exact etiology of in utero passage of meconium remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

Rathoria

Bansal

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.

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Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections

Abstract: Editorial group: Cochrane Pregnancy and Childbirth Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 11, 2014.

Cited by 33 publications

References 36 publications

Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term

Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term

Meconium‐stained amniotic fluid exposure is associated with a lower incidence of offspring long‐term infectious morbidity

Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

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