Idiopathic Polyhydramnios: Severity and Perinatal Morbidity

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Idiopathic polyhydramnios, characterized by excessive amniotic fluid without a clear cause, presents potential risks during pregnancy.
• Understanding the association between polyhydramnios severity and adverse perinatal outcomes is crucial for clinical management.

Purpose of the Study:

• To investigate the relationship between the severity of idiopathic polyhydramnios and adverse pregnancy outcomes.
• To determine if increasing severity of polyhydramnios correlates with a higher risk of specific neonatal complications.

Main Methods:

• Retrospective cohort study of 10,536 pregnancies with amniotic fluid index (AFI) measurements.
• Exclusion of pregnancies with diabetes, multiples, or known fetal anomalies.
• Categorization of polyhydramnios severity: normal (AFI 5-24 cm), mild (≥24-30 cm), and moderate-severe (>30 cm).

Main Results:

• Idiopathic polyhydramnios was associated with increased odds of neonatal intensive care unit (NICU) admission (AOR 3.71), postpartum hemorrhage (AOR 15.81), macrosomia (AOR 3.41), low 5-minute Apgar score (AOR 2.60), and cesarean delivery (AOR 2.16).
• A dose-response relationship was observed, with increasing polyhydramnios severity correlating with higher odds of macrosomia and low 5-minute Apgar scores.
• Moderate-severe polyhydramnios showed significantly increased odds for macrosomia (AOR 4.44) and low 5-minute Apgar scores (AOR 3.93) compared to mild cases.

Conclusions:

• Idiopathic polyhydramnios is an independent risk factor for adverse perinatal morbidity.
• The severity of idiopathic polyhydramnios appears to have a dose-response effect on the risks of neonatal macrosomia and low 5-minute Apgar scores.