Association between borderline amniotic fluid levels and adverse perinatal outcome: systematic review and meta-analysis
Abstract
Objectives: The aim of the present study was to evaluate adverse perinatal outcomes in low-risk singleton pregnancies with borderline oligohydramnios.
Methods: A comprehensive literature search was conducted for observational cohort studies that compared perinatal outcomes in low-risk singleton pregnancies between those with borderline oligohydramnios, defined as an amniotic fluid index (AFI) of 5.1-8.0 cm, and those with a normal AFI. EMBASE, MEDLINE and Web of Science databases were searched for studies published from inception to July 2024. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed using a random-effects model to calculate pooled proportions and 95% CIs for each outcome in both groups. The outcomes assessed included overall Cesarean delivery (CD), CD owing to fetal distress, 5-min Apgar score < 7, low birth weight (LBW), admission to the neonatal intensive care unit (NICU), meconium-stained amniotic fluid, meconium aspiration syndrome, non-reassuring fetal heart rate during labor, operative vaginal delivery and neonatal death.
Results: The search yielded 6902 results, of which eight met the inclusion criteria for the meta-analysis. From these eight studies, 799 singleton pregnancies with borderline oligohydramnios and 1512 singleton pregnancies with normal AFI were analyzed. Analysis revealed an association of borderline oligohydramnios with increased risks of overall CD (odds ratio (OR), 2.20 (95% CI,…
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