ETIOLOGY OF NEONATAL MECONIUM-STAINED AMNIOTIC FLUID IN BAGHDAD: A CASE–CONTROL STUDY

Background: Meconium-stained amniotic fluid is a common obstetric finding that signals potential fetal compromise and is associated with adverse perinatal outcomes, including meconium aspiration syndrome and neonatal intensive care admission.
Objective: To identify risk factors associated with meconium-stained amniotic fluid in neonates delivered at a tertiary maternity and children's hospital in Baghdad.
Methods: A hospital-based case–control study was conducted from 1 January to 31 December 2023. A total of 100 neonates were enrolled: 50 with meconium staining of the amniotic fluid at birth (cases) and 50 without staining (controls). Data on gestational age, mode and duration of labour, fetal distress, maternal illness, ruptured membranes and obstructed labour were recorded using a structured questionnaire and analyzed with SPSS version 24.0. Odds ratios with 95% confidence intervals, Fisher's exact test and descriptive statistics were used.
Results: Fetal distress was present in 60% of cases versus 4% of controls (odds ratio 36.0, 95% CI 7.9–165.2, p < 0.001). Caesarean delivery occurred in 80% of cases versus 50% of controls (odds ratio 4.0, 95% CI 1.7–9.7, p = 0.003) and prolonged labour in 90% versus 60% (odds ratio 6.0, 95% CI 2.0–17.7, p = 0.001). No statistically significant association was found with maternal illness, premature rupture of membranes, obstructed labour or maternal age. Four neonates died.
Conclusions: Fetal distress, caesarean delivery and prolonged labour are significant risk factors for meconium-stained amniotic fluid. Early recognition of these factors may improve surveillance and neonatal outcome.