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Objective To examine the risk of meconium aspiration syndrome (MAS) by the week of gestational age in pregnancies with meconium-stained amniotic fluid (MSAF).Methods This is a retrospective cohort study derived from term pregnancies at a single tertiary institution over an 18-year period. Outcomes analyzed included MAS, acidemia, and Apgar scores. Univariate analysis was performed using chi-square and multivariable logistic regression was used to adjust for potential confounders.Results A total of 34,303 deliveries ≥37 weeks were included