{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:56:00Z","timestamp":1788555360039,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Our objective was to study the strength of the association between meconium\u2010stained amniotic fluid and severe morbidity among neonates of nulliparas with prolonged pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a secondary analysis of the NOCETER randomized trial that took place between 2009 and 2012 in which 11 French maternity units included 1373 nulliparas at 41<jats:sup>+0<\/jats:sup>\u2009weeks of gestation onwards with a single live fetus in cephalic presentation. This analysis excluded patients with a cesarean delivery before labor and those with bloody amniotic fluid or of unreported consistency. The principal end point was a composite criterion of severe neonatal morbidity (neonatal death, 5\u2010minute Apgar &lt;7, convulsions in the first 24\u2009h, meconium aspiration syndrome, mechanical ventilation \u226524\u2009h, or neonatal intensive care unit admission for 5\u2009days or more). The neonatal outcomes of pregnancies with thin or thick meconium\u2010stained amniotic fluid were compared with those with normal amniotic fluid. The association between the consistency of the amniotic fluid and neonatal morbidity was tested by univariate and then multivariate analysis adjusted for gestational age at birth, duration of labor, and country of birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 1274 patients: 803 (63%) in the group with normal amniotic fluid, 196 (15.4%) in the thin amniotic fluid group, and 275 (21.6%) in the thick amniotic fluid group. The neonates of patients with thick amniotic fluid had higher rates of neonatal morbidity than those of patients with normal amniotic fluid (7.3% vs. 2.2%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; adjusted relative risk [aRR] 3.3, 95% confidence interval [CI] 1.7\u20136.3), but those of patients with thin amniotic fluid did not (3.1% vs. 2.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.50; aRR 1.0, 95% CI, 0.4\u20132.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among nulliparas at 41<jats:sup>+0<\/jats:sup>\u2009weeks onwards, only thick meconium\u2010stained amniotic fluid is associated with a higher rate of severe neonatal morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14619","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T12:10:14Z","timestamp":1687954214000},"page":"1092-1099","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Meconium\u2010stained amniotic fluid and neonatal morbidity in nulliparous patients with prolonged pregnancy"],"prefix":"10.1111","volume":"102","author":[{"given":"Isabelle","family":"Attali","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Robert Debr\u00e9 Hospital, AP\u2010HP Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3074-8269","authenticated-orcid":false,"given":"Diane","family":"Korb","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Robert Debr\u00e9 Hospital, AP\u2010HP Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Azria","sequence":"additional","affiliation":[{"name":"CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA Universit\u00e9 de Paris  Paris France"},{"name":"Maternity Unit, Groupe Hospitalier Paris Saint Joseph, FHU PREMA Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0574-3749","authenticated-orcid":false,"given":"Jacques","family":"Lepercq","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris Maternit\u00e9 Port\u2010Royal  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[{"name":"CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA Universit\u00e9 de Paris  Paris France"},{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris Maternit\u00e9 Port\u2010Royal  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Robert Debr\u00e9 Hospital, AP\u2010HP Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Groupe de Recherche en Obst\u00e9trique et Gyn\u00e9cologie (GROG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"329","article-title":"Meconium: a 1990s perspective on an old obstetric hazard","volume":"83","author":"Nathan L","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443619965020"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610600797426"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.531329"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.03.035"},{"key":"e_1_2_11_7_1","first-page":"378","article-title":"Effect of meconium\u2010stained amniotic fluid on perinatal complications in low\u2010risk pregnancies at term","volume":"33","author":"Hiersch L","year":"2016","journal-title":"Am J Perinatol"},{"key":"e_1_2_11_8_1","first-page":"183","article-title":"Meconium\u2010stained amniotic fluid and neonatal morbidity in low\u2010risk pregnancies at term: the effect of gestational age","volume":"34","author":"Hiersch L","year":"2017","journal-title":"Am J Perinatol"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.11.1.54.59"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182117a26"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050223"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000544"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2007.10.005"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1179\/146532808X335642"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.04.016"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.858320"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-019-0436-4"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00407-1"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004040000088"},{"key":"e_1_2_11_20_1","first-page":"184","article-title":"Anjali: meconium staining of amniotic fluid\u2010 a poor indicator of fetal compromise","volume":"12","author":"Duhan N","year":"2010","journal-title":"JK Sci"},{"key":"e_1_2_11_21_1","article-title":"Association of Apgar Score with Meconium Staining of amniotic fluid in labor","volume":"13","author":"Masood M","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(98)00141-9"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16852-9"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13592"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T10:31:11Z","timestamp":1743849071000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/aogs.14619"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14619","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]},"assertion":[{"value":"2023-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}