Abstract: 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.

Key words: meconium-stained amniotic fluid;　necrotizing enterocolitis;　preterm;　very low birth weight infant