Adverse Perinatal Outcomes in Isolated Borderline Amniotic Fluid Index at Term Pregnancies

Objective: To determine the frequency of adverse perinatal outcomes, specifically low Apgar scores and NICU admissions, in term pregnancies with isolated borderline AFI, and to assess the influence of maternal age and parity on these outcomes. Methodology: This prospective observational study was conducted in the Department of Obstetrics and Gynecology of Watim Hospital, Rawalpindi from August 2024 to November 2024. A total of 163 gravid women aged 20 to 35 years with singleton pregnancy (37- 40 weeks) and isolated borderline AFI: 5–8 cm, were included in the study. Written informed consent was taken. AFI was measured by ultrasound. Data was analyzed using SPSS version 22.0. Results: The majority aged 20-30 years (27.4±3.68). Most deliveries occurred between 37-38 weeks' gestation, with a mean gestational age of 38.23 ± 0.97 weeks. Neonatal outcomes showed that 36.8% of newborns had an APGAR score <7 at 1 minute, which improved significantly to 18.4% at 5 minutes. NICU admission was required in 67.5% of cases. Stratification analysis showed that neonates of mothers aged 20-30 years have higher rates of low APGAR scores at both 1 minute and 5 minutes compared to those aged 31-35 years. Primiparous women had more neonates with APGAR scores <7 at 1 minute and 5 minutes than multiparous women. Conclusion: There is significant perinatal morbidity due to isolated borderline AFI resulting in low Apgar scores and consequently higher NICU admissions in term pregnancies. The patient’s age and parity influenced the outcomes.