Hostname: page-component-7479d7b7d-m9pkr Total loading time: 0 Render date: 2024-07-11T02:02:34.113Z Has data issue: false hasContentIssue false
  • English
  • Français

Isolated oligohydramnios and long-term neurological morbidity of the offspring

Published online by Cambridge University Press:  22 November 2019

Avital Dorot Open the ORCID record for Avital Dorot [Opens in a new window] ,
Tamar Wainstock ,
Eyal Sheiner ,
Asnat Walfisch ,
Daniella Landau  and
Avi Harlev
Avital Dorot
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Tamar Wainstock
Affiliation:
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eyal Sheiner
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Asnat Walfisch
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Daniella Landau
Affiliation:
Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Avi Harlev*
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
Address for correspondence: Avi Harlev, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Email: Harlev@bgu.ac.il
Get access Rights & Permissions [Opens in a new window]

Abstract

This study aimed to assess the association between maternal-isolated oligohydramnios (IO) and offspring long-term neurological complications. A population-based retrospective cohort study was conducted, including all births at a single tertiary medical center in Israel between the years 1991 and 2014. Multiple pregnancies and potential pregnancy complications associated with oligohydramnios were excluded. The computerized obstetrical database was linked with the computerized dataset of all pediatric hospitalizations of the same medical center. Evaluation of cumulative neurological-associated hospitalizations rate over time was compared using a Kaplan–Meier survival curve. The Weibull survival parametric model was conducted to assess the neurological-associated hospitalization risk in the presence of IO, while accounting for potential confounders. A total of 190,259 pregnancies were included in the study, of which 4063 (2.13%) pregnancies were complicated with IO. Total neurological-related hospitalizations were significantly more common in the IO group (3.7% in the IO group and 3.0% in the comparison group, p = 0.005). Pervasive developmental disorder, movement disorders, developmental disorders, and degenerative and demyelization disorders were all specific neurological diagnoses significantly more common in the exposed group. The survival curve demonstrated a significantly higher cumulative hospitalization rate in the exposed group (log-rank p = 0.001). Using a multivariate model adjusting for gestational age, maternal age, and labor induction, an independent association between IO and long-term neurological morbidity of the offspring was observed (adjusted hazard ratio 1.203; 95% CI 1.02–1.42). In summary, a significant association was found between pregnancies complicated by IO and long-term neurological morbidity of the offspring.

Keywords

idiopathic oligohydramniosdecreased amniotic fluidlong-term outcomemovement disordersdevelopmental disordersfetal development
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 6 , December 2020 , pp. 648 - 652
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

The first two authors contributed equally to the manuscript.

References

Rossi, AC, Prefumo, F. Perinatal outcomes of isolated oligohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2013; 169(2), 149–154.CrossRefGoogle ScholarPubMed
Apel-Sarid, L, Levy, A, Holcberg, G, Sheiner, E. Placental pathologies associated with intra-uterine fetal growth restriction complicated with and without oligohydramnios. Arch Gynecol Obstet. 2009; 280(4), 549–552.CrossRefGoogle ScholarPubMed
Guron, G, Friberg, P. An intact rennin-angiotensin system is a prerequisite for normal renal development. J Hypertens. 2000; 18(2), 123–137.CrossRefGoogle Scholar
Pryde, PG, Sedman, AB, Nugent, CE, Barr, M , Jr. Angiotensin-converting enzyme inhibitor fetopathy. J Am Soc Nephrol. 1993; 3(9), 1575–1582.Google ScholarPubMed
Fanos, V, Marcialis, MA, Bassareo, PP, et al. Renal safety of Non Steroidal Anti Inflammatory Drugs (NSAIDs) in the pharmacologic treatment of patent ductus arteriosus. J Matern Fetal Neonatal Med. 2011; 24(Suppl 1), 50–52.CrossRefGoogle ScholarPubMed
Abou-Ghannam, G, Usta, IM, Nassar, AH. Indomethacin in pregnancy: applications and safety. Am J Perinatol. 2012; 29(3), 175–186.Google ScholarPubMed
Moore, TR. Amniotic fluid dynamics reflect fetal and maternal health and disease. Obstet Gynecol. 2010; 116(3), 759–765.CrossRefGoogle ScholarPubMed
Feldman, I, Friger, M, Wiznitzer, A, Mazor, M, Holcberg, G, Sheiner, E. Is oligohydramnios more common during the summer season? Arch Gynecol Obstet. 2009; 280(1), 3–6.CrossRefGoogle ScholarPubMed
Harman, CR. Amniotic fluid abnormalities. Semin Perinatol. 2008; 32(4), 288–294.CrossRefGoogle ScholarPubMed
Gizzo, S, Noventa, M, Vitagliano, A, et al. An update on maternal hydration strategies for amniotic fluid improvement in isolated oligohydramnios and normohydramnios: evidence from a systematic review of literature and meta-analysis. PloS One. 2015; 10(12), e0144334.CrossRefGoogle ScholarPubMed
Underwood, MA, Gilbert, WM, Sherman, MP. Amniotic fluid: not just fetal urine anymore. J Perinatol. 2005; 25(5), 341–348.CrossRefGoogle ScholarPubMed
Magann, EF, Chauhan, SP, Kinsella, MJ, McNamara, MF, Whitworth, NS, Morrison, JC. Antenatal testing among 1001 patients at high risk: the role of ultrasonographic estimate of amniotic fluid volume. Am J Obstet Gynecol. 1999; 180(6 Pt 1), 1330–1336.CrossRefGoogle ScholarPubMed
Zhang, J, Troendle, J, Meikle, S, Klebanoff, MA, Rayburn, WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004; 111(3), 220–225.CrossRefGoogle Scholar
Ott, WJ. Reevaluation of the relationship between amniotic fluid volume and perinatal outcome. Am J Obstet Gynecol. 2005; 192(6), 1803–1809.CrossRefGoogle ScholarPubMed
Hsieh, TT, Hung, TH, Chen, KC, Hsieh, CC, Lo, LM, Chiu, TH. Perinatal outcome of oligohydramnios without associated premature rupture of membranes and fetal anomalies. Gynecol Obstet Invest. 1998; 45(4), 232–236.CrossRefGoogle ScholarPubMed
Leibovitch, L, Kuint, J, Rosenfeld, E, Schushan-Eisen, I, Weissmann-Brenner, A, Maayan-Metzger, A. Short-term outcome among term singleton infants with intrapartum oligohydramnios. Acta Paediatr. 2012; 101(7), 727–730.CrossRefGoogle ScholarPubMed
Shrem, G, Nagawkar, SS, Hallak, M, Walfisch, A. Isolated oligohydramnios at term as an indication for labor induction: a systematic review and meta-analysis. Fetal Diagn Ther. 2016; 40(3), 161–173.CrossRefGoogle ScholarPubMed
Rabie, N, Magann, E, Steelman, S, Ounpraseuth, S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017; 49(4), 442–449.CrossRefGoogle ScholarPubMed
Chien, LN, Chiou, HY, Wang, CW, Yeh, TF, Chen, CM. Oligohydramnios increases the risk of respiratory hospitalization in childhood: a population-based study. Pediatr Res. 2014; 75(4), 576–581.CrossRefGoogle ScholarPubMed
Sasahara, J, Ishii, K, Umehara, N, et al. Significance of oligohydramnios in preterm small-for-gestational-age infants for outcome at 18 months of age. J Obstet Gynaecol Res. 2016; 42(11), 1451–1456.CrossRefGoogle ScholarPubMed
Godfrey, KM, Barker, DJ. Fetal programming and adult health. Public Health Nutr. 2001; 4(2B), 611–624.CrossRefGoogle ScholarPubMed
Barker, DJ. The origins of the developmental origins theory. J Intern Med. 2007; 261(5), 412–417.CrossRefGoogle ScholarPubMed
Wallack, L, Thornburg, K. Developmental origins, epigenetics, and equity: moving upstream. Matern Child Health J. 2016; 20(5), 935–940.CrossRefGoogle ScholarPubMed
Moster, D, Lie, RT, Markestad, T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008; 359(3), 262–273.CrossRefGoogle ScholarPubMed
Raju, TN, Pemberton, VL, Saigal, S, et al. Long-term healthcare outcomes of preterm birth: an executive summary of a conference sponsored by the national institutes of health. J Pediatr. 2016; 181, 309–318.e1.CrossRefGoogle ScholarPubMed
Wu, CS, Chen, CM, Chou, HC. Pulmonary hypoplasia induced by oligohydramnios: findings from animal models and a population-based study. Pediatr Neonatol. 2017; 58(1), 3–7.CrossRefGoogle ScholarPubMed
Husain, AN, Hessel, RG. Neonatal pulmonary hypoplasia: an autopsy study of 25 cases. Pediatr Pathol. 1993; 13(4), 475–484.CrossRefGoogle ScholarPubMed
Houben, JJ. Immediate and delayed effects of oligohydramnios on limb development in the rat: chronology and specificity. Teratology. 1984; 30(3), 403–411.CrossRefGoogle ScholarPubMed
Christianson, C, Huff, D, McPherson, E. Limb deformations in oligohydramnios sequence: effects of gestational age and duration of oligohydramnios. Am J Med Genet. 1999; 86(5), 430–433.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Roberts, D, Nwosu, EC, Walkinshaw, SA. The fetal outcome in pregnancies with isolated reduced amniotic fluid volume in the third trimester. J Perinat Med. 1998; 26(5), 390–395.CrossRefGoogle ScholarPubMed
Altshuler, G. Some placental considerations related to neurodevelopmental and other disorders. J Child Neurol. 1993; 8(1), 78–94.CrossRefGoogle ScholarPubMed
Nabhan, AF, Abdelmoula, YA. Amniotic fluid index versus single deepest vertical pocket: a meta-analysis of randomized controlled trials. Int J Gynaecol Obstet. 2009; 104(3), 184–188.CrossRefGoogle ScholarPubMed
Rosati, P, Guariglia, L, Cavaliere, AF, et al. A comparison between amniotic fluid index and the single deepest vertical pocket technique in predicting adverse outcome in prolonged pregnancy. J Prenat Med. 2015; 9(1–2), 12–15.Google ScholarPubMed
Chauhan, SP, Sanderson, M, Hendrix, NW, Magann, EF, Devoe, LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999; 181(6), 1473–1478.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Dorot et al. supplementary material

Appendix S1

Download Dorot et al. supplementary material(PDF)
PDF 170.1 KB