Meta-Analysis: Amniotic Meconium and Low Birth Weight as Predictors of Asphyxia in Newborns

Abstract

Background: Preterm birth, intrapartumrelated complications (birth asphyxia or difficulty breathing at birth), infections and birth defects accounted for the majority of neonatal deaths in 2017. Low birth weight and amniotic fluid with meconium are factors associated with perinatal asphyxia. The aim of this study was to conduct a meta-analysis to estimate the influence of meconium in the amniotic fluid and low birth weight on the risk of asphyxia in newborns based on the results of previous similar studies. Subjects and Method: This was a systematic review and meta-analysis following the PRISMA flow diagram. The formula for PICO is as follows: P= newborn, I= mixed amniotic fluid with low birth weight, C = clear amniotic fluid and normal birth weight (≥2,500 g). Database: PubMed, Google Scholar, Clinical Key, Springer Link and Science Direct with keywords ("asphyxia" OR "birth asphyxia") AND ("meconium stained amniotic" OR "meconium stained liquor" OR "meconium stained amniotic liquor") AND "Low birth weight" AND "newborns" AND "cross sectional". The research inclusion criteria were full text articles and in English. Articles published from 2010 to 2020. The study design was cross-sectional with multivariate analysis using Revman 5.3 and results reported in adjusted odds ratio (aOR). Results:The results of the meta-analysis in 11 primary studies showed that the effect of meconium in the amniotic fluid was statistically significant in increasing the risk of asphyxia in newborns by 5.16 times compared to clear membranes (aOR 5.16; 95% CI = 3.73-7.13; p <0.001). The effect of low birth weight was statistically significant in increasing the risk of asphyxia in newborns by 2.94 times compared to normal birth weight (aOR 2.94; 95% CI = 1.84-4.70; p <0.001). Conclusion: Amniotic meconium and low birth weight increase the incidence of newborn asphxia. Early detection in proper control and monitoring of labor, development of a comprehensive partograph and adequate prenatal care with the provision of social support reduces the frequency and negative effects of perinatal asphyxia.

Determinants of Low Fifth Minute Apgar Score among Newborn Delivered at health facilities in Ethiopia,systematic review and meta-analysis

“…The results of meta-analysis of 7 studies evidenced that birth weight < 2500 gram were 4.82 times (AOR:4.82,95%CI:3.72-5.91) more likely to have low 5th minute Apgar score as compared to newborn with birthweight > 2500 gram among newborns in Ethiopia. This is in lined with meta-analysis reported that low birth weight had low Apgar score (32).This might be due to the fact that low birth weight occurs as a result of maternal complications before conception or antepartum period.…”

“…This review showed that meconium-stained amniotic uid were signi cantly associated with low 5-minute Apgar score. These ndings were similar to systematic review done on effects of meconium-stained amniotic uid and low birth weight on birth asphyxia (32,33).The possible reason might meconium-Page 8/13 stained amniotic uid had major impact on mode of delivery and newborn outcome.…”