Evaluation of the efficacy of maternal hemogram parameters in predicting meconium presence at birth in healthy pregnancies

Abstract

The presence of meconium-stained amniotic fluid (MSAF) is a critical indicator of fetal distress, associated with increased neonatal morbidity and mortality. The aim of this study was to evaluate the potential of maternal blood parameters to predict the presence of meconium-stained amniotic fluid (MSAF) in term pregnancies. Data were retrospectively analyzed from healthy pregnant women who presented to Samsun Education and Research Hospital between 2014 and 2023 and delivered either by normal spontaneous delivery or cesarean section. The study included healthy pregnant women aged 18 and over who gave birth between 37 and 42 weeks of gestation. The non-invasive laboratory parameters investigated were neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SIRI), aggregate index of systemic inflammation (AISI), and procalcitonin levels. Results showed that NLR, MLR, SIRI, AISI, and procalcitonin levels were significantly higher in the MSAF group. The ROC curve analysis demonstrated that SIRI (cutoff: 3.55) had an AUC of 0.826 (sensitivity: 89.2%, specificity: 71.8%). AISI (cutoff: 1340.39) had an AUC of 0.749 (sensitivity: 75.8%, specificity: 70.9%). NLR (cutoff: 3.58) showed an AUC of 0.757 (sensitivity: 87.5%, specificity: 56.3%). MLR (cutoff: 0.55) presented an AUC of 0.822 (sensitivity: 87.5%, specificity: 74.8%). However, SII demonstrated negligible and statistically non-significant diagnostic value. PLR and procalcitonin exhibited lower diagnostic efficacy. This study demonstrates that NLR, MLR, SIRI, AISI, and procalcitonin are effective non-invasive biomarkers for predicting the presence of MSAF in term pregnancies. These parameters can assist clinicians in anticipating fetal distress and the risk of meconium aspiration syndrome (MAS), thereby improving perinatal outcomes through timely intervention.

Keywords

• meconium
• amniotic fluid
• inflammation mediators
• biomarkers

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