Publication:

Borderline amniotic fluid index at term: does it independently predict adverse maternal and perinatal outcomes? A prospective comparative study

Background Borderline amniotic fluid index (AFI 5.1-8.0 cm) represents a gray zone in obstetrics, with uncertain association with adverse maternal and perinatal outcomes. Objective was to compare outcomes in term pregnancies with borderline and normal AFI and assess whether borderline AFI independently predicts adverse outcomes.

Methods This prospective observational study included 160 singleton term pregnancies (≥37 weeks), divided into borderline AFI (n=80) and normal AFI (n=80) groups. After loss to follow-up, 74 and 72 women were analyzed. Maternal and perinatal outcomes were compared, and multivariate logistic regression was performed.

Results Borderline AFI was associated with higher induction of labor (59.4% versus 32.4%, p=0.001) and failed induction (22.9% versus 5.6%, p=0.002). Caesarean delivery was significantly higher among induced women (44.7% versus 18.2%, p=0.037), though overall rates were comparable. Non-progression of labor, fetal distress, and meconium-stained liquor were more frequent in the borderline AFI group. Borderline AFI independently predicted low birth weight (AOR: 2.76, p=0.006) but not caesarean delivery.

Conclusions Borderline AFI is associated with increased intrapartum interventions and low birth weight. However, it does not independently predict caesarean delivery, emphasizing the role of labor-related factors in clinical outcomes.