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To determine if low amniotic fluid index(AFI) is associated with higher rate of perinatal morbidity, perinatal outcome was compared according to AFI in 503 pregnant women who had undertaken AFI measurement within 2 weeks before delivery from 18 to 44 weeks gestation. In 459 and 44 pregnant women AFI were 5 to 95 percentile(normal AFI group and below 5 percentile(low AFI group) of our standard, respectively. The gestation age at delivery and birth weight of low AFI group were lower than those normal one(38.5±2.5 weeks versus 39.5±2.1, p<0.01 weeks, and 2.80±0.65kg versus 3.21±0.51kg, p<0.005, respectively). The incidences of low 1-minurte and 5-minutes Apgar scores, intrauterine growth retardation, admission to neonatal intensive care unit and preterm deliveries were significantly higher in low AFI group that in normal group. However, the incidences of neonatal mortality, cesarean section due to fetal distress, and meconium staining were not statistically different between two groups probably due to small sample sizes. The sensitivity, specificity, positive predictive value, and negative predictive value of low AFI in predicting the abnormal delivery delivery outcome, which was defined by low 5-minutes Apgar score(<7), intrauterine growth retardation, cesarean section duet to fetal distress, admission to neontal intensive care unit, and neonatal mortality, were 19.5%, 93.3%, 36.4% and 85.6%, respectively. Low AFI may be of some value as a antenatal fetal survailance method with respect of its high specificity and negative predictive alue of poor perinatal outcome.
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