Dataset Information

Amniotic fluid disorders and the effects on prenatal outcome: a retrospective cohort study.

ABSTRACT:

Background

The amniotic fluid is a protective liquid present in the amniotic sac. Two types of amniotic fluid disorders have been identified. First refers to polyhydramnios, which is an immoderate volume of amniotic fluid with an Amniotic Fluid Index (AFI) greater than 24?cm. Second includes oligohydramnios, which refers to decreased AFI i.e., less than 5?cm. This study aims to; a) identify the maternal risk factors associated with amniotic fluid disorders, b) assess the effect of amniotic fluid disorders on maternal and fetal outcome c) examine the mode of delivery in pregnancy complicated with amniotic fluid disorders.

Methods

A comparative retrospective cohort study design is followed. Sample of 497 pregnant women who received care at King Abdullah bin Abdul-Aziz University Hospital (KAAUH) between January 2017 to October 2019 was included. Data were collected from electronic medical reports, and was analyzed using descriptive statistics. Association of qualitative variables was conducted by Chi-square test, where p-value ResultsAmong the collected data, 2.8% of the cases had polyhydramnios and 11.7% patients had oligohydramnios. One case of still born was identified. A statically significant association was found between polyhydramnios and late term deliveries (P?=?0.005) and cesarean section (CS) rates (P?=?0.008). The rate of term deliveries was equal in normal AFI and oligohydramnios group (P?=?0.005). Oligohydramnios was mostly associated with vaginal deliveries (P?=?0.008). Oligohydramnios and polyhydramnios were found to be associated with diabetes mellitus patients (P?=?0.005), and polyhydramnios with gestational diabetes patients (P?=?0.052). Other maternal chronic diseases showed no effect on amniotic fluid index, although it might cause other risks on the fetus.

Conclusion

Diabetes mellitus and gestational diabetes are the most important maternal risk factors that can cause amniotic fluid disorders. Maternal and fetal outcome data showed that oligohydramnios associated with gestational age at term and low neonatal birth weight with high rates of vaginal deliveries, while polyhydramnios associated with gestational age at late term and high birth weight with higher rates of CS.

SUBMITTER: Bakhsh H

PROVIDER: S-EPMC7821638 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Amniotic fluid disorders and the effects on prenatal outcome: a retrospective cohort study.

Bakhsh H H Alenizy H H Alenazi S S Alnasser S S Alanazi N N Alsowinea M M Alharbi L L Alfaifi B B

BMC pregnancy and childbirth 20210122 1

<h4>Background</h4>The amniotic fluid is a protective liquid present in the amniotic sac. Two types of amniotic fluid disorders have been identified. First refers to polyhydramnios, which is an immoderate volume of amniotic fluid with an Amniotic Fluid Index (AFI) greater than 24 cm. Second includes oligohydramnios, which refers to decreased AFI i.e., less than 5 cm. This study aims to; a) identify the maternal risk factors associated with amniotic fluid disorders, b) assess the effect of amniot ...[more]

PMID: 33482755

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Project description:BackgroundEvidence has indicated that some non-inherited factors such as exposure to environmental pollutants are associated with neurodevelopment disorders like autism spectrum disorder (ASD). Studies report that endocrine disrupting compounds (EDCs), including polychlorinated biphenyls, organochlorine pesticides, perfluoroalkyl substances (PFAS), and some metals, have adverse effects on the fetal neurodevelopment. The aim of this study was to measure the amniotic fluid (AF) levels of EDCs and metals as well as the receptor transactivities induced by AF and investigate the possible link between prenatal exposure to EDCs and heavy metals and ASD risk.MethodsIn this case-control study, we included AF samples of 75 ASD cases and 135 frequency-matched controls and measured the levels of the endogenous sex hormones, PFAS, and elements including heavy metals. The combined effect of endogenous hormones and EDCs on the receptor of estrogen (ER), androgen (AR), aryl hydrocarbon (AhR), and thyroid hormone-like activity were also determined and expressed as receptor ligand equivalents. We assessed the associations of AF levels of chemicals, sex hormones, and receptor activities with ASD risk using unconditional logistical regression analyses. To control for multiple comparisons, the false discovery rate (FDR) was used and q values less than 0.25 were designated as statistical significance.ResultsPFAS and metals were detectable in AF samples. The ASD cases had significantly lower AF levels of PFAS than controls, and the adjusted odds ratio (OR) was 0.410 (95% CI 0.174, 0.967; p?=?0.042; FDR q value?=?0.437) for perfluorooctane sulfonate (PFOS). The principal component, including PFAS congeners, copper, iron, and estrogenic activity, was significantly inversely associated with ASD risk (adjusted OR?=?0.100; 95% CI 0.016, 0.630; p?=?0.014; FDR q value?=?0.098).Testosterone level in AF weakly associated with ASD risk (adjusted OR?=?1.002; 95% CI 1.000, 1.004; p?=?0.05). However, after multiple comparison correction, the association was not significant (FDR q value?=?0.437). No significant associations between AF-induced receptor transactivities and ASD risk were observed. The adjusted OR was 2.176 (95%CI 0.115, 41.153) for the ratio of the combined androgenic activity to combined estrogenic activity.ConclusionsThe presence of PFAS and heavy metals in AF indicates that they can cross the placenta. The inverse association between levels of PFAS congeners in AF and ASD risk might relate to the weak estrogenic activities and anti-androgenic activities of PFAS.The observed tendency of positive association between the ratio of combined androgenic effect to the combined estrogenic effect and ASD risk needs further studies to explore whether EDCs together with endogenous hormones play a role in the development of ASD.

Dataset Information

Amniotic fluid disorders and the effects on prenatal outcome: a retrospective cohort study.

Background

Methods

Conclusion

Publications

Amniotic fluid disorders and the effects on prenatal outcome: a retrospective cohort study.

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