目的　探究早产极低出生体质量儿羊水胎粪污染（MSAF）与新生儿坏死性小肠结肠炎（NEC）的相关性以及 NEC发生的危险因素。方法　以2010年1月至2016年10月住院的胎龄<34周、出生体质量<1 500 g的新生儿为研究对象， 按照胎龄相差3天内、出生体质量相差130 g内的标准，1:5配对收集MSAF及非MSAF新生儿，回顾分析两组新生儿母 孕期基本特征及围生期并发症。结果　共收集460例早产极低出生体质量儿，其中41例（8.9%）合并有MSAF，最终纳入 MSAF组30例、非MSAF组150例。MSAF组的NEC发生率为26.7%，高于非MSAF组的10.0%，差异有统计学意义（P=0.028）。 Logistic回归分析显示，MSAF（OR=3.39，95%CI=1.35~8.49， P=0.009）和败血症（OR=3.54，95%CI=1.44~8.68， P=0.011）是NEC发生的独立危险因素。结论　MSAF和败血症是早产极低出生体质量儿NEC发生的危险因素。

Objective　To evaluate the association between meconium-stained amniotic fluid (MSAF) and necrotizing enterocolitis (NEC) in very low birth weight preterm infants and to identify the risk factors of NEC. Methods　A retrospective study was conducted from January 2010 to October 2016. The maternal and neonatal characteristics in cases of very-low-birthweight preterm infants born prior to 34 weeks of gestation were collected. Infants were divided into the MSAF and non-MSAF groups. Each infant exposed to MSAF was matched with 5 infants from the control group who were admitted to our ward during the same study period according to gestational age (difference ≤ 3 days), birth weight (difference ≤ 130 g) and age at admission (difference ≤ 3 days). Results　In present study, 460 medical records of preterm infants with very low birth weight were reviewed. Forty-one (41，8.9%) of them were born with MSAF. A total of 180 infants were finally involved in the study. Demographic characteristics and neonatal complication of MSAF (n=30) and non-MSAF group (n=150) were compared. Higher incidence of NEC (26.7% vs. 10%, χ2=4.825, P=0.028) was found in MSAF group in comparison to non-MSAF group. In logistic regression analysis, MSAF (OR=3.385, 95.0%CI: 1.349-8.492, P=0.009) and sepsis (OR=3.538, 95.0%CI: 1.442-8.679, P=0.006) were independent risk factors of NEC. Conclusion　MSAF is associated with higher incidence of NEC in very low birth weight infants. MSAF and sepsis contributed to the development of NEC. Strengthening the management of amniotic fluid contamination during pregnancy might reduce the incidence of NEC.