Meconium Staining Amniotic Fluid And Risk Of Adverse Pregnancy Outcomes Of Intrahepatic Cholestasis Of Pregnancy:A Systematic Review

ObjectiveTo systematic review literature regarding the relationship between Meconium Staining Amniotic Fluid and risk of adverse pregnancy outcomes of intrahepatic cholestasis of pregnancy (intrahepatic cholestasis of pregnancy,ICP).MethodsThe following databases including The Cochrane Library, PubMed, Web of science, CBM, CNKI, VIP and Wan Fang(from inception to August,2015) were searched on computer. Cohort or case-control studies were identified according to the inclusion and exclusion criteria. The quality of the included studies was assessed according to NOS for Systematic Review, and Meta-analysis was conducted by using RevMan 5.3 software.ResultsA total of 5 cohort studies involving 1332 patients were included. The results of meta-analysis showed that:ICP with MSAF can increase the risk of premature rupture of membranes, low birth weight, fetal distress, neonatal asphyxia, perinatal mortality, cesarean delivery; the OR value and 95%CI were 2.43 (1.54,3.84).2.05 (1.34, 3.15),2.20 (1.45,3.35),5.88 (3.65,9.45),15.13 (5.08,45.12) and 1.91 (1.00, 3.64).respectively.ConclusionThe risk of premature rupture of membranes, low birth weight, fetal distress, neonatal asphyxia, perinatal infants death and cesarean delivery is much higher when ICP with MASF.The MASF means worse pregnancy outcomes in ICP patients. Because of the limited quality of retrospective studies, there is a need to develop more high-quality prospective study to further validate these results.