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The association between pregnancies complicated with isolated polyhydramnios or oligohydramnios and offspring
Aviv Amitai1, Tamar Wainstock2, Eyal Sheiner3
1Department of Obstetrics and Gynecology, Soroka University Medical Center, POB 151, 84101, Beer-Sheva, Israel.
Insights
Infants exposed to low amniotic fluid (oligohydramnios) in utero face a higher risk of long-term gastrointestinal (GI) problems. This study confirms oligohydramnios as an independent risk factor for childhood GI morbidity.
Area of Science:
- Perinatal Medicine
- Pediatric Gastroenterology
- Reproductive Health
Background:
- Pregnancies with abnormal amniotic fluid volumes, specifically polyhydramnios (excess fluid) or oligohydramnios (low fluid), are linked to adverse perinatal outcomes.
- The long-term gastrointestinal (GI) health implications for offspring exposed to these conditions in utero remain an area requiring further investigation.
Purpose of the Study:
- To determine if in utero exposure to amniotic fluid abnormalities, namely oligohydramnios and polyhydramnios, increases the risk of long-term GI morbidity in children.
Main Methods:
- A population-based cohort study analyzed GI-related hospitalizations up to age 18 in singletons exposed versus unexposed to oligohydramnios or polyhydramnios.
- Data were collected from deliveries between 1991-2014 at a tertiary medical center, using ICD-9 codes to define GI morbidity.
- Kaplan-Meier curves and Cox proportional hazard models were employed to assess cumulative incidence and control for confounding factors.
Main Results:
- The study included 186,196 newborns; 2.1% had oligohydramnios and 3.0% had polyhydramnios.
- Children exposed to isolated oligohydramnios showed a significantly higher cumulative incidence of GI morbidity compared to unexposed children (p=0.001).
- Isolated oligohydramnios was independently associated with increased long-term GI morbidity (adjusted HR 1.2, p=0.007), while polyhydramnios was not (adjusted HR 1.1, p=0.766).
Conclusions:
- In utero exposure to isolated oligohydramnios is an independent risk factor for developing long-term gastrointestinal morbidity in offspring.
- These findings highlight the importance of monitoring and managing pregnancies complicated by oligohydramnios to mitigate potential long-term GI health issues in children.
Objective:
Infants born to mothers with pregnancies complicated by polyhydramnios or oligohydramnios are at an increased risk for significant adverse perinatal outcome. We sought to assess whether in utero exposure to amniotic fluid abnormalities increases the risk of long-term gastrointestinal (GI) morbidity in the offspring.
Methods:
In a population-based cohort study, the incidence of GI-related hospitalizations was compared between singletons exposed and unexposed to oligohydramnios or polyhydramnios. Deliveries occurred between the years 1991-2014 in a regional tertiary medical center. Offspring GI morbidity was assessed up to the age of 18 years according to a pre-defined set of International Classification of Diseases, ninth revision (ICD-9) codes associated with hospitalization. A Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. A Cox proportional hazard model was performed to control for confounders.
Results:
During the study period, 186,196 newborns met the inclusion criteria, of which 2.1% (n = 4063) and 3.0% (n = 5684) were born following pregnancies with oligohydramnios and polyhydramnios, respectively. The Kaplan-Meier curve demonstrated that children exposed to isolated oligohydramnios (but not to polyhydramnios) had higher cumulative incidence of GI morbidity (log-rank test, p = 0.001). In the Cox regression model, controlled for maternal age, gestational age, birth weight, and mode of delivery, isolated oligohydramnios (adjusted HR 1.2, 95% CI 1.04-1.34, p = 0.007), but not polyhydramnios (adjusted HR 1.1, 95% CI 0.91-1.13, p = 0.766), was found to be independently associated with long-term GI morbidity of the offspring.
Conclusion:
In utero exposure to isolated oligohydramnios is an independent risk factor for long-term GI morbidity in the offspring.
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