Risk of meconium-stained amniotic fluid in different ethnic groups.

BACKGROUND: Recent studies indicate that the risk of meconium-stained amniotic fluid (MSAF) varies in different ethnic groups. This study prospectively examined the ethnic variation of MSAF and meconium aspiration syndrome, adjusting for gravidity, gestational age (GA), and birth weight.

METHOD: The study population consisted of 6901 consecutive live births and included 31 different nationalities, seven main ethnic (race) groups, gravidity between 1 and 19, GA between 22 and 44 weeks, and birth weights between 350 and 6292 gm.

RESULTS: The overall incidence of MSAF was 19% (13% thin, 6% thick). The prevalence of meconium aspiration syndrome was 5% in thick MSAF and none in thin MSAF. The incidence of MSAF differs significantly by ethnicity (14% to 30%), gravidity (17% to 23%), GA (6% to 46%), and birth weight (11% to 28%). Multivariate logistic regression analysis using the same variable showed that being black African, post-term, with a gravidity of > or = 7 and a birth weight of > or = 4000 gm significantly increased the chance for MSAF but not meconium aspiration syndrome. After controlling for these clinical variables, the black African infants had a higher percentage of MSAF at all GAs compared with the other ethnic groups.

CONCLUSION: This study showed that the risk of MSAF varied by ethnicity and increased with higher gravidity, a GA of > 42 weeks, and a birth weight of > or = 4000 gm The higher incidence of MSAF without an increase in meconium aspiration syndrome in some ethnic groups may indicate advancing maturity of the gastrointestinal system in black ethnic groups compared with others of the same GA.