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Meta-Analysis: Amniotic Meconium and Low Birth Weight as Predictors of Asphyxia in Newborns
[摘要] Background: Preterm birth, intrapartum-related complications (birth asphyxia or diffi­culty breathing at birth), infections and birth defects accounted for the majority of neonatal deaths in 2017. Low birth weight and amniotic fluid with meconium are factors associated with perinatal asphyxia. The aim of this study was to conduct a meta-analysis to estimate the influ­ence of meconium in the amniotic fluid and low birth weight on the risk of asphyxia in new­borns based on the results of previous similar studies. Subjects and Method: This was a systematic review and meta-analysis following the PRISMA flow diagram. The formula for PICO is as follows: P= newborn, I= mixed amniotic fluid with low birth weight, C = clear amniotic fluid and normal birth weight (≥2,500 g). Data­base: PubMed, Google Scholar, Clinical Key, Springer Link and Science Direct with key­words ("asphyxia" OR "birth asphy­xia") AND ("meconium stained amniotic" OR "meconium stained liquor" OR "meconium stained amnio­tic liquor") AND "Low birth weight" AND "new­borns" AND "cross sectio­nal". The research inclusion criteria were full text articles and in English. Articles published from 2010 to 2020. The study design was cross-sectional with multivariate analysis using Revman 5.3 and results reported in adjusted odds ratio (aOR). Results: The results of the meta-analysis in 11 primary studies showed that the effect of meconium in the amniotic fluid was statistically significant in increasing the risk of asphyxia in newborns by 5.16 times compared to clear membranes (aOR 5.16; 95% CI = 3.73-7.13; p <0.001). The effect of low birth weight was statistically significant in increasing the risk of asphyxia in newborns by 2.94 times compared to normal birth weight (aOR 2.94; 95% CI = 1.84-4.70; p <0.001). Conclusion: Amniotic meconium and low birth weight increase the incidence of newborn asphxia. Early detection in proper control and monitoring of labor, development of a com­prehensive partograph and adequate prenatal care with the provision of social support reduces the frequency and negative effects of perinatal asphyxia.
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[关键词] meconium in the amniotic fluid;low birth weight;asphyxia;newborns [时效性] 
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