Related Experiment Video
Updated: Jun 23, 2026
08:50
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Meconium-stained amniotic fluid: discharge vigorous newborns
Y van Ierland1, M de Boer, A J de Beaufort
1Division of Neonatology, Juliana Children's Hospital, The Hague, The Netherlands. y.vanierland@erasmusmc.nl
Archives of Disease in Childhood. Fetal and Neonatal Edition
|April 28, 2009
Summary
Infants born through meconium-stained amniotic fluid (MSAF) with a good 5-minute Apgar score rarely develop meconium aspiration syndrome (MAS). These newborns can be safely discharged earlier, reducing unnecessary postnatal observation.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Obstetrics
Background:
- Meconium-stained amniotic fluid (MSAF) affects a significant number of births.
- Routine 24-hour postnatal observation is standard for infants born via MSAF.
- Meconium aspiration syndrome (MAS) is a serious complication, but occurs in only 5% of MSAF infants.
Purpose of the Study:
- To assess the clinical utility of the standard 24-hour postnatal observation period for neonates exposed to MSAF.
- To identify predictive factors for the development of MAS in infants born through MSAF.
Main Methods:
- A cohort study of 394 term neonates born through MSAF.
- Collection of data on Apgar scores at 5 minutes and the incidence of MAS.
- Analysis of perinatal factors associated with MAS development.
Main Results:
- The incidence of MAS in the cohort was 4.8% (19 out of 394 infants).
- Infants with a 5-minute Apgar score (5'AS) of ≥9 had a significantly lower incidence of MAS (0.3%) compared to those with 5'AS ≤8 (19%).
- A 5'AS of ≥9 was a strong indicator of low risk for MAS development.
Conclusions:
- The development of MAS is rare in infants born through MSAF who have a 5-minute Apgar score of 9 or higher.
- Neonates born through MSAF with a 5'AS ≥9 may be safely discharged earlier than 24 hours.
- Risk stratification using Apgar scores can optimize postnatal observation protocols for MSAF infants.
Related Concept Videos
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:22Development of Immunocompetence
The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:30Development of Human Microbiota
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...
01:14Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:15Transcytosis of IgG
Transcytosis is the process in which molecules are internalized by endocytosis, transported across the cell, and released through exocytosis from the opposite end of the cell. Molecules such as insulin, immunoglobulins, and certain nutrients are transferred through the recycling endosomes by recycling and transcytosis.
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...