Abstract
Objective
Amniotic fluid abnormalities are often associated with adverse short-term pregnancy outcome. Little is known about long-term gastrointestinal (GI) complications in offspring following pregnancies with isolated abnormal amniotic fluid volume. We sought to assess whether in-utero exposure to amniotic fluid abnormalities increases the risk of long-term GI offspring morbidity.
Study Design
In a population based cohort study, the incidence of GI disorders was compared between singletons exposed and non-exposed to oligohydramnios (amniotic fluid index [AFI] <5 cm) or polyhydramnios (AFI>24 cm). Deliveries occurred between the years 1991-2014 in a regional tertiary medical center. GI morbidity was assessed up to the age of 18 years according to a predefined set of ICD-9 codes associated with hospitalization of the offspring. Multiple gestations, perinatal deaths, patients lacking prenatal care, and children with congenital malformations or chromosomal abnormalities were excluded from the study. A Cox proportional hazard model was performed to control for confounders.
Results
During the study period 186,196 newborns met the inclusion criteria, of which 2.1% (n= 4,063) and 3.0% (n=5,684) were in pregnancies diagnosed with oligohydramnios and polyhydramnios, respectively. While isolated polyhydramnios was not associated with a higher risk of GI morbidity in the offspring, children exposed to isolated oligohydramnios had significantly higher rates of GI related morbidity (Table). In the Cox regression model, while controlling for maternal age, gestational age, birth-weight, and mode of delivery, isolated oligohydramnios (adjusted HR; 1.2, 95% CI 1.04-1.34, p= 0.007), but not polyhydramnios (adjusted HR; 1.1, 95% CI 0.91-1.34, p= 0.766), was found to be independently associated with long-term GI morbidity of the offspring.
Conclusion
In utero exposure to isolated oligohydramnios is an independent risk factor for long-term GI offspring morbidity.
Amniotic fluid abnormalities are often associated with adverse short-term pregnancy outcome. Little is known about long-term gastrointestinal (GI) complications in offspring following pregnancies with isolated abnormal amniotic fluid volume. We sought to assess whether in-utero exposure to amniotic fluid abnormalities increases the risk of long-term GI offspring morbidity.
Study Design
In a population based cohort study, the incidence of GI disorders was compared between singletons exposed and non-exposed to oligohydramnios (amniotic fluid index [AFI] <5 cm) or polyhydramnios (AFI>24 cm). Deliveries occurred between the years 1991-2014 in a regional tertiary medical center. GI morbidity was assessed up to the age of 18 years according to a predefined set of ICD-9 codes associated with hospitalization of the offspring. Multiple gestations, perinatal deaths, patients lacking prenatal care, and children with congenital malformations or chromosomal abnormalities were excluded from the study. A Cox proportional hazard model was performed to control for confounders.
Results
During the study period 186,196 newborns met the inclusion criteria, of which 2.1% (n= 4,063) and 3.0% (n=5,684) were in pregnancies diagnosed with oligohydramnios and polyhydramnios, respectively. While isolated polyhydramnios was not associated with a higher risk of GI morbidity in the offspring, children exposed to isolated oligohydramnios had significantly higher rates of GI related morbidity (Table). In the Cox regression model, while controlling for maternal age, gestational age, birth-weight, and mode of delivery, isolated oligohydramnios (adjusted HR; 1.2, 95% CI 1.04-1.34, p= 0.007), but not polyhydramnios (adjusted HR; 1.1, 95% CI 0.91-1.34, p= 0.766), was found to be independently associated with long-term GI morbidity of the offspring.
Conclusion
In utero exposure to isolated oligohydramnios is an independent risk factor for long-term GI offspring morbidity.
| Original language | English GB |
|---|---|
| Pages (from-to) | S85-S85 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |