Intrapartum risk factors for neonatal intensive care unit admission in pregnancies with grade III meconium-stained amniotic fluid

OBJECTIVES: To analyze the high-risk factors of neonatal intensive care unit (NICU) admission in grade III meconium-stained amniotic fluid (MSAF) pregnancies and offer recommendations for clinical practice. METHODS: Clinical data from 517 women with grade III MSAF during delivery were gathered for analysis. Two groups were examined using multivariable logistic regression in order to identify high-risk factors associated with NICU admission. The area under the receiver operating characteristic curve (ROC) was calculated to assess the relationship between NICU admission and blood tests during delivery. RESULTS: The NICU admission group displayed a higher prevalence of thick meconium-stained amniotic fluid, a greater number of balloon catheter usage, worse routine blood test results during delivery, and higher 24 h vaginal bleeding volume, while lower rate of spontaneous membrane rupture. Logistic regression analysis identified abnormal fetal heart rate, maternal fever, and thick amniotic fluid as risk factors for NICU admission. Furthermore, ROC curve showed white blood cell (WBC) count and neutrophil percentage had a certain value of prediction for NICU admission. CONCLUSIONS: When grade III MSAF was found during delivery, if there is concurrent abnormal fetal heart monitoring, maternal fever and thick AF, a more cautious perinatal observation, a reasonable selection of delivery methods, and timely early resuscitation of newborns should be employed.