Idiopathic polyhydramnios at term and pregnancy outcomes: a multicenter observational study

Abstract

Aim: To assess pregnancy outcomes in pregnancies with idiopathic polyhydramnios at term.

Methods: We conducted a retrospective cohort study of 106 225 term pregnancies from 37 hospitals in China. Maternal and fetal outcomes in pregnancies with idiopathic polyhydramnios were compared with pregnancies with normal amniotic fluid. The primary outcome was intra-uterine fetal death (IUFD).

Results: In all, 307 out of 106 225 (0.3%) had idiopathic polyhydramnios at term, 276 of which were mild and 31 of which were moderate-severe. Compared to term pregnancies with normal amniotic fluid, pregnancies idiopathic polyhydramnios was associated with over 24-fold higher risk for IUFD (adjusted odds ratio [aOR] 24.4, 95% confidence interval (CI) 7.3–82.0), macrosomia (aOR 2.8, 95%CI 2.0–3.8), malpresentation (aOR 2.5, 95%CI 1.7–3.7), cesarean delivery (aOR 2.5, 95%CI 1.7–3.7) and low APGAR scores at 5 min (aOR 4.3, 95%CI 2.4–7.8), which increased with severity of idiopathic polyhydramnios.

Conclusion: Term pregnancies with idiopathic polyhydramnios, especially moderate–severe ones are at a significantly increased rate for adverse pregnancy outcome. Increased antepartum surveillance of fetal well-being and timed delivery are warranted.

Keywords:

• Idiopathic polyhydramnios
• term pregnancy
• pregnant outcome
• amniotic fluid

Acknowledgements

The research was part of the project supported by “Health industry special funds for Public Benefit Research Foundation” from the Ministry of Health, People’s Republic of China (Grant number 201002013), Science and Technology Program of Sichuan Province (No.2015JY0209), and was supported by National Natural Science Foundation of China (No. 81170584 and 81370733 to Li Zou).

We thank the subjects for their participation and medical staff member involved in this survey at the following hospitals: We thank the subjects for their participation and medical staff involved in this survey at the following hospitals: Capital Medical University Beijing Obstetrics and Gynecology Hospital, Capital Medical University Friendship Hospital (Li Lin), Obstetrics and Gynecology Hospital of Fudan University (Xiaotian Li), First Affiliated Hospital of Medical College of Xi’an Jiaotong University (Wenli Gou), Nanjing Drum Tower Hospital (Yali Hu), Shandong Provincial Hospital (Xietong Wang), the Second Affiliated Hospital of West China Hospital (Xinghui Liu), Shengjing Hospital of China Medical University (Caixia Liu), Nanfang Hospital of Nanfang Medical University (Yanhong Yu), the Second Hospital of Jilin University (Yanhui Zhao), the First Affiliated Hospital of Xinjiang Medical University (Qiming Zhu), Hebei Changzhou Central Hospital (Junfeng Zhang), the First Affiliated Hospital of Inner Shandong Provincial Hospital

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.