Neonatal Outcomes at Term with Meconium-stained Amniotic Fluid in A Tertiary Hospital in Pakistan

Background: Meconium-stained amniotic fluid (MSAF) is a common intrapartum finding in term pregnancies and is associated with increased neonatal morbidity, particularly respiratory complications such as meconium aspiration syndrome. Aim: To determine the impact of meconium-stained amniotic fluid on neonatal outcomes in term pregnancies. Methods: This prospective cohort study was carried out at the Department of Obstetrics and Gynecology, Gulab Devi Teaching Hospital five months (from November 2025 to March 2025) following ethical approval. 196 women having singleton term pregnancies were recruited and separated into two groups 98 who had MSAF and 98 who had clear amniotic fluid. Mother demographics, labor, and neonatal outcomes were noted. Statistical data analysis was performed with SPSS version 28 and Chi-square and independent t-tests with statistical significance level of p < 0.05. Results: At 1 minute (6.21 1.34 vs. 7.48 1.12; p < 0.001) and 5 minutes (7.82 1.09 vs. 8.91 0.76; p < 0.001) Apgar was significantly lower in the MSAF group. Meconium aspiration syndrome (18.4% vs. 3.1%; p = 0.001), respiratory distress (29.6% vs. 11.2%; p = 0.001), NICU admission (26.5% vs. 9.2%; p = 0.002) and need of resuscitation (22.4% vs. 7.1%; p = 0.003) were all significantly higher in the MSAF group. Exposed neonates had a further NICU stay (4.72 ± 1.83 vs. 2.31 ± 1.14 days; p < 0.001). The MSAF group also had a higher mortality rate (6.1% vs. 1.0%). Conclusion: The presence of meconium in an amniotic fluid was significantly linked with increased morbidity and mortality of the neonatal condition among term pregnancies. Early diagnosis and immediate neonatal care are necessary to enhance the outcomes of perinatal care.