Meconium-stained amniotic fluid across gestation and neonatal acid-base status
Meconium-stained amniotic fluid across gestation and neonatal acid-base status
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DOI：
10.1097/01.aog.0000226853.85609.8d
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发表时间：
2006-08-01
影响因子：
7.2
通讯作者：
Smulian, John C.
中科院分区：
文献类型：
--
作者：
Oyelese, Yinka;Culin, Angelina;Smulian, John C.
目的：估计是否胎粪污染羊水的妇女所生的新生儿的酸碱状态在整个gestation.METHODS：我们进行了一项回顾性队列研究，所有妊娠并发胎粪污染的羊水在2004年。病例从围产期病理学数据库中确定，该数据库包含所有妊娠合并胎粪污染羊水的数据。从图表中提取的数据包括分娩时的胎龄、脐动脉pH值、出生体重和是否分娩。根据分娩时的胎龄对病例进行分层。计算胎粪污染羊水在整个妊娠期的分布。整个妊娠期的平均脐动脉pH值（95%的置信区间）进行了评估方差analysis of variance.Results：平均脐动脉pH值与羊水粪染的妇女没有不同的整个妊娠期。羊水粪染的总发生率为12.0%（6,403例分娩中的766例）。羊水粪染率从32周时的1.2%上升到42周时的100%.CONCLUSION：羊水粪染的发生率随孕周的增加而增加，这与胎儿成熟是导致羊水粪染的主要因素的假设是一致的。此外，缺乏变化的平均脐动脉pH值在整个妊娠表明，胎儿酸血症不增加时，胎粪通过发生在怀孕早期，而不是在孕龄后期。
OBJECTIVE: To estimate whether the acid-base status of neonates born to women with meconium-stained amniotic fluid varies across gestation.METHODS: We carried out a retrospective cohort study of all pregnancies that were complicated by meconium-stained amniotic fluid in 2004. Cases were identified from a perinatal pathology database that contained data on all pregnancies complicated by meconium-stained amniotic fluid. Data abstracted from the charts included gestational age at delivery, umbilical arterial pH, birth weight and the presence or absence of labor. Cases were stratified according to gestational age at delivery. The distribution of meconium-stained amniotic fluid across gestation was computed. The mean umbilical arterial pH values (with 95% confidence intervals) across gestation were assessed by analysis of variance.RESULTS: The mean umbilical arterial pH in women with meconium-stained amniotic fluid did not differ across gestation. The overall incidence of meconium-stained amniotic fluid was 12.0% (766 of 6,403 deliveries). The rates of meconium-stained amniotic fluid increased from 1.2% at 32 weeks to 100% at 42 weeks.CONCLUSION: The rising incidence of meconium-stained amniotic fluid with gestational age is consistent with the hypothesis that fetal maturation is a major etiologic factor in meconium passage. Also, the lack of variation of mean umbilical arterial pH across gestation suggests that fetal acidemia is not increased when meconium passage occurs earlier in pregnancy rather than at later gestational ages.