{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T03:00:31Z","timestamp":1781319631834,"version":"3.54.1"},"reference-count":24,"publisher":"Walter de Gruyter GmbH","issue":"5","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Natural Science Foundation of Jiangsu ProvinceNational Natural Science Foundation of ChinaProject of Jiangsu Health Commission","award":["BK20191070"],"award-info":[{"award-number":["BK20191070"]}]},{"name":"Natural Science Foundation of Jiangsu ProvinceNational Natural Science Foundation of ChinaProject of Jiangsu Health Commission","award":["81971407"],"award-info":[{"award-number":["81971407"]}]},{"name":"Natural Science Foundation of Jiangsu ProvinceNational Natural Science Foundation of ChinaProject of Jiangsu Health Commission","award":["H2019008"],"award-info":[{"award-number":["H2019008"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0322_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0322_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0322_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u202fh 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0322_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0322","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:50:21Z","timestamp":1777164621000},"page":"861-866","source":"Crossref","is-referenced-by-count":0,"title":["Intrapartum risk factors for neonatal intensive care unit admission in pregnancies with grade III meconium-stained amniotic fluid"],"prefix":"10.1515","volume":"54","author":[{"given":"Cen","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runrun","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junling","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiping","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"2026061302442417168_j_jpm-2025-0322_ref_001","unstructured":"Nathan, L, Leveno, KJ, Carmody, TJ, Kelly, MA, Sherman, ML. Meconium: a 1990s perspectiveon an old obstetric hazard. Obstet Gynecol 1994;83:329\u201332."},{"key":"2026061302442417168_j_jpm-2025-0322_ref_002","doi-asserted-by":"crossref","unstructured":"Alchalabi, H, Abu-Heija, AT, El-Sunna, E, Zayed, F, Badria, LF, Obeidat, A. Meconium-stained amniotic fluid in term pregnancies-a clinical view. J\u00a0Obstet Gynaecol 1999;19:262\u20134. https:\/\/doi.org\/10.1080\/01443619965020.","DOI":"10.1080\/01443619965020"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_003","doi-asserted-by":"crossref","unstructured":"Lee, K, Lee, S, Yang, H, Park, C, Mazaki-Tovi, S, Yoon, B, et al.. The frequency\u00a0of meconium-stained amniotic fluid increases as a function\u00a0of the duration of labor. J\u00a0Matern Fetal Neonatal Med 2011;24:880\u20135. https:\/\/doi.org\/10.3109\/14767058.2010.531329.","DOI":"10.3109\/14767058.2010.531329"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_004","unstructured":"Yurdakok, M. Meconium aspiration syndrome: do we know? Turk J Pediatr 2011;53:121\u20139."},{"key":"2026061302442417168_j_jpm-2025-0322_ref_005","doi-asserted-by":"crossref","unstructured":"Khazardoost, S, Hantoushzadeh, S, Khooshideh, M, Borna, S. Risk factors for meconium aspiration in meconium stained amniotic fluid. J\u00a0Obstet Gynaecol 2007;27:577\u20139. https:\/\/doi.org\/10.1080\/01443610701469636.","DOI":"10.1080\/01443610701469636"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_006","unstructured":"Berkus, MD, Langer, O, Samueloff, A, Xenakis, EM, Field, NT, Ridgway, LE. Meconium-stained amniotic fluid: increased risk for adverse neonatal outcome. Obstet Gynecol 1994;84:115\u201320."},{"key":"2026061302442417168_j_jpm-2025-0322_ref_007","doi-asserted-by":"crossref","unstructured":"Spinillo, A, Fazzi, E, Capuzzo, E, Stronati, M, Piazzi, G, Ferrari, A. Meconium-stained amniotic fluid and risk for cerebral palsy in preterm infants. Obstet Gynecol 1997;90:519\u201323. https:\/\/doi.org\/10.1016\/s0029-7844(97)00308-6.","DOI":"10.1016\/S0029-7844(97)00308-6"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_008","doi-asserted-by":"crossref","unstructured":"Tran, SH, Caughey, AB, Musci, TJ. Meconium-stained amniotic fluid is associated with puerperal infections. Am J Obstet Gynecol 2003;189:746\u201350. https:\/\/doi.org\/10.1067\/s0002-9378(03)00767-1.","DOI":"10.1067\/S0002-9378(03)00767-1"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_009","doi-asserted-by":"crossref","unstructured":"Locatelli, A, Regalia, AL, Patregnani, C, Ratti, M, Toso, L, Ghidini, A. Prognostic value of change in amniotic fluid color during labor. Fetal Diagn Ther 2005;20:5\u20139. https:\/\/doi.org\/10.1097\/01.ogx.0000167201.82860.31.","DOI":"10.1159\/000081359"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_010","doi-asserted-by":"crossref","unstructured":"Parween, S, Prasad, D, Poonam, P, Ahmar, R, Sinha, ., Ranjana, R.. Impact of meconium-stained amniotic fluid on neonatal outcome in a tertiary hospital. Cureus 2022;14:e24464. https:\/\/doi.org\/10.7759\/cureus.24464.","DOI":"10.7759\/cureus.24464"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_011","doi-asserted-by":"crossref","unstructured":"Malakooti, N, Mehrnoush, V, Abdi, F, Farashah, MSV, Darsareh, F. Development of a machine learning model to identify the predictors of the neonatal intensive care unit admission. Sci Rep 2025;15:20914. https:\/\/doi.org\/10.1038\/s41598-025-06651-0. PMID: 40596456; PMCID: PMC12215917.","DOI":"10.1038\/s41598-025-06651-0"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_012","unstructured":"Yang, M, Wang, JM. Perinatal risk factors for the occurrence of singleton apparently stillborn infants. Zhongguo Dang Dai Er Ke Za Zhi 2023;25:18\u201324. https:\/\/doi.org\/10.7499\/j.issn.1008-8830.2207108."},{"key":"2026061302442417168_j_jpm-2025-0322_ref_013","doi-asserted-by":"crossref","unstructured":"ACOG Practice Bulletin No. 106. Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol 2009;114:192\u2013202. https:\/\/doi.org\/10.1097\/AOG.0b013e3181aef106.","DOI":"10.1097\/AOG.0b013e3181aef106"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_014","doi-asserted-by":"crossref","unstructured":"G\/Silassie, R, Gebretsadik, W, Degefa, N, Getahun, D, Kassie, N. Determinants of meconium-stained amniotic fluid at hadiya zone hospitals, southern Ethiopia; unmatched case-control study. Int J Womens Health 2022;14:1351\u201360. https:\/\/doi.org\/10.2147\/IJWH.S376963.","DOI":"10.2147\/IJWH.S376963"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_015","doi-asserted-by":"crossref","unstructured":"Zhu, X, Huang, S, Tang, Y, Wu, Z, Sun, Y, Ren, H, et al.. Once we find grade III meconium stained amniotic fluid, must we act as early as possible? Int J Womens Health 2023;15:7\u201323. https:\/\/doi.org\/10.2147\/IJWH.S385356.","DOI":"10.2147\/IJWH.S385356"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_016","doi-asserted-by":"crossref","unstructured":"Altshuler, G, Hyde, S. Meconium-induced vasocontraction: a potential cause of cerebral and other fetal hypoperfusion and of poor pregnancy outcome. J\u00a0Child Neurol 1989;4:137\u201342. https:\/\/doi.org\/10.1177\/088307388900400214.","DOI":"10.1177\/088307388900400214"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_017","doi-asserted-by":"crossref","unstructured":"Poggi, SH, Ghidini, A. Pathophysiology of meconium passage into the amniotic fluid. Early Hum Dev 2009;85:607\u201310. https:\/\/doi.org\/10.1016\/j.earlhumdev.2009.09.011.","DOI":"10.1016\/j.earlhumdev.2009.09.011"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_018","doi-asserted-by":"crossref","unstructured":"Sheiner, E, Hadar, A, Shoham-Vardi, I, Hallak, M, Katz, M, Mazor, M. The effect of meconium on perinatal outcome: a prospective analysis. J\u00a0Matern Fetal Neonatal Med 2002;11:54\u20139. https:\/\/doi.org\/1080\/jmf.11.1.54.59.","DOI":"10.1080\/jmf.11.1.54.59"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_019","doi-asserted-by":"crossref","unstructured":"Towers, CV, Yates, A, Zite, N, Smith, C, Chernicky, L, Howard, B. Incidence of fever in labor and risk of neonatal sepsis. Am J Obstet Gynecol 2017;216:596.e1\u2013596.e5. https:\/\/doi.org\/10.1016\/j.ajog.2017.02.022. Epub 2017 Feb 16.","DOI":"10.1016\/j.ajog.2017.02.022"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_020","doi-asserted-by":"crossref","unstructured":"Perlman, JM. Maternal fever and neonatal depression: preliminary observations. Clin Pediatr 1999;38:287\u201391. https:\/\/doi.org\/10.1177\/000992289903800506.","DOI":"10.1177\/000992289903800506"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_021","doi-asserted-by":"crossref","unstructured":"An, H, Zheng, W, Zhu, Q, Wen, H. Retrospective study of intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes. PeerJ 2022;10:e14242. https:\/\/doi.org\/10.7717\/peerj.14242.","DOI":"10.7717\/peerj.14242"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_022","doi-asserted-by":"crossref","unstructured":"Romero, R, Hanaoka, S, Mazor, M, Athanassiadis, AP, Callahan, R, Hsu, YC, et al.. Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity. Am J Obstet Gynecol 1991;164:859\u201362. https:\/\/doi.org\/10.1016\/0002-9378(91)90529-z.","DOI":"10.1016\/0002-9378(91)90529-Z"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_023","doi-asserted-by":"crossref","unstructured":"Hochler, H, Lipschuetz, M, Guedalia, J, Karavani, G, Cohen, SM, Yagel, S, et al.. The impact of peak and duration of maternal intrapartum fever on perinatal outcomes. American Journal of Obstetrics & Gynecology MFM 2021;3:100390. https:\/\/doi.org\/10.1016\/j.ajogmf.2021.100390.","DOI":"10.1016\/j.ajogmf.2021.100390"},{"key":"2026061302442417168_j_jpm-2025-0322_ref_024","doi-asserted-by":"crossref","unstructured":"Shekari, M, Jahromi, MS, Ranjbar, A, Mehrnoush, V, Darsareh, F, Roozbeh, N. The incidence and risk factors of meconium amniotic fluid in singleton pregnancies: an experience of a tertiary hospital in Iran. BMC Pregnancy Childbirth 2022;22:930. https:\/\/doi.org\/10.1186\/s12884-022-05285-8.","DOI":"10.1186\/s12884-022-05285-8"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0322\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0322\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:47:15Z","timestamp":1781318835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0322\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,2,16]]},"published-print":{"date-parts":[[2026,6,24]]}},"alternative-id":["10.1515\/jpm-2025-0322"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2025-0322","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"value":"0300-5577","type":"print"},{"value":"1619-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}