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Meconium-stained amniotic fluid and risk for cerebral palsy in preterm infants
A Spinillo1, E Fazzi, E Capuzzo
1Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, Pavia, Italy.
Objective:
To estimate the risk for cerebral palsy in preterm infants in relation to the presence of meconium in the amniotic fluid (AF).
Methods:
A cohort study was conducted of 404 consecutive preterm infants delivered between 24 and 33 weeks' gestation at a single institution. Sociodemographic and clinical data were collected at birth. The diagnosis of cerebral palsy was made at 2 years' corrected age. Politomous logistic regression models were used to evaluate the odds for cerebral palsy while adjusting for potential confounders.
Results:
The overall prevalence of cerebral palsy among survivors was 11.6% (40/345). The cerebral palsy rate was 41.2% (7/17) among infants who were meconium-stained at birth and 10% (33/328) among those who were not (P = .006 by Fisher exact test). After adjustment for potential confounders (gestational age and fetal gender), the odds ratio of cerebral palsy among infants delivered to women with meconium-stained AF was 6.9 (95% confidence interval 2.32, 20.81, P = .001) relative to those delivered to women with clear AF.
Conclusion:
The results of the present study support the view that the presence of meconium in the AF is a gestational age-independent risk factor for cerebral palsy among preterm infants.