Idiopathic Polyhydramnios and Neonatal Morbidity at Term

Area of Science:

• Maternal-Fetal Medicine
• Neonatology
• Obstetrics

Background:

• Idiopathic polyhydramnios is a common cause of polyhydramnios, but its impact on neonatal outcomes remains debated.
• Existing evidence on the association between idiopathic polyhydramnios and neonatal morbidity is conflicting.
• This study addresses the need for clarity on the relationship between idiopathic polyhydramnios and adverse neonatal outcomes at term.

Purpose of the Study:

• To investigate the association between idiopathic polyhydramnios and neonatal morbidity in term pregnancies.
• To compare neonatal outcomes in pregnancies with and without idiopathic polyhydramramnios.
• To identify specific neonatal morbidities linked to idiopathic polyhydramnios.

Main Methods:

• Retrospective cohort study of singleton, term pregnancies (2014-2018).
• Exclusion of pregnancies with fetal anomalies, pregestational diabetes, or multifetal gestation.
• Definition of idiopathic polyhydramnios by deepest vertical pocket (DVP) ≥8 cm or amniotic fluid index (AFI) ≥24 cm; matched 1:2 with controls by gestational age and maternal race.

Main Results:

• Idiopathic polyhydramnios (n=192) was associated with a significantly increased risk of composite neonatal morbidity (21.4% vs. 5.5%; aRR=4.0).
• Term neonatal respiratory morbidity was the primary driver of increased morbidity (20.3% vs. 4.2%; aRR=4.8).
• Higher rates of continuous positive airway pressure (CPAP) and supplemental oxygen were observed in neonates born to mothers with idiopathic polyhydramnios.

Conclusions:

• Idiopathic polyhydramnios is linked to a higher risk of neonatal morbidity, especially respiratory complications, in term deliveries.
• Neonates born with idiopathic polyhydramnios often require respiratory support shortly after birth.
• Further research is warranted to develop strategies for reducing neonatal morbidity associated with idiopathic polyhydramnios.