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Meta-Analysis
. 2024 Mar 4;14(1):5296.
doi: 10.1038/s41598-024-54840-0.

Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis

Konstantinos S Kechagias  1 , Konstantinos Katsikas Triantafyllidis  2 , Georgia Zouridaki  3 , Makrina Savvidou  3   4
Affiliations
Meta-Analysis

Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis

Konstantinos S Kechagias et al. Sci Rep. .

Abstract

Although the assessment of the amniotic fluid volume in pregnancy is part of the fetal wellbeing surveillance, the impact of idiopathic polyhydramnios (IP) on maternal and perinatal outcomes in unknown. The aim of this meta-analysis was to investigate the association of IP with different maternal and perinatal outcomes. We screened five electronic databases until December 2023 and performed data extraction and quality assessment using ROBINS-E in duplicates. Pooled risk ratios and 95% confidence intervals (95% CI) were calculated with a random effects model. 38 studies were included. Patients with IP were at increased risk of perinatal complications including preterm delivery (RR 1.96, 95% CI 1.35-2.86; I2 = 92%), placental abruption (RR 3.20, 95% CI 2.20-4.65; I2 = 2%), delivery via caesarean section (RR 1.60, 95% CI 1.39-1.84; I2 = 95%) and postpartum haemorrhage (RR 1.98, 95% CI 1.22-3.22; I2 = 84%). Similarly, IP was associated with increased risk of adverse perinatal outcomes including low APGAR score (RR 3.0, 95% CI 1.23-7.35; I2 = 95%), stillbirth (RR 4.75, 95% CI 2.54-8.86; I2 = 9%) and perinatal mortality (RR 4.75, 95% CI 2.67-8.48; I2 = 37%). This meta-analysis suggests that pregnant women with IP may be at increased risk of perinatal complications and adverse neonatal outcomes. However, data remains inconclusive considering the low quality and high heterogeneity of included studies.PROSPERO registration number: CRD42022359944.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
Figure 2
Figure 2
Association of idiopathic polyhydramnios with the risk of (a) Preterm birth (b) PPROM (c) PIH/PET (d) Labour induction (e) Placental abruption (f) Shoulder dystocia (g) Caesarean section (h) PPH (i) Abnormal 1 m APGAR (j) Abnormal 5 m APGAR (k) NICU admission (l) Stillbirth (m) Perinatal mortality. 1 m: 1 min/5 m: 5 min; 95% CI 95% confidence interval; APGAR appearance, pulse, grimace, activity, and respiration score; IP idiopathic polyhydramnios; NICU neonatal intensive care unit; PIH/PET pregnancy induced hypertension/pre-eclamptic toxaemia; PPH post-partum haemorrhage; PPROM preterm premature rapture of membranes; RR risk ratio; IV inverse variance.
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