Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas.

Abstract

OBJECTIVE:

Investigate marked variability in fetal heart rate (FHR) patterns before delivery and its association with neonatal morbidity and abnormal arterial cord gases.

STUDY DESIGN:

Prospective cohort of laboring patients at term. Composite neonatal morbidity (respiratory distress, mechanical ventilation, suspected sepsis, meconium aspiration syndrome, therapeutic hypothermia, hypoxic-ischemic encephalopathy, seizure, and death) and abnormal arterial cord gases (pH < 7.10, lactate ≥ 4 mmol/L, base deficit < -12 mEq/L) were assessed with multivariable logistic regression.

RESULT:

Three hundred and ninety (4.5%) neonates had marked variability in FHR patterns before delivery. There was no difference in composite neonatal morbidity (aRR 1.22; 95% CI 0.91-1.63), though neonates with marked variability in FHR patterns were more likely to have a respiratory distress (aRR 1.85; 95% CI 1.25-2.70). There was an increased risk of composite abnormal arterial cord gases (aRR 1.66; 95% CI 1.47-1.88).

CONCLUSION:

Marked variability in FHR patterns was not associated with composite neonatal morbidity but was associated with abnormal arterial cord gases.

• Authors: Brock Polnaszek, Julia D López, Reece Clark, Nandini Raghuraman, George A Macones, Alison G Cahill
• Journal: Journal of perinatology : official journal of the California Perinatal Association (J Perinatol) Vol. 40 Issue 1 Pg. 56-62 (01 2020) ISSN: 1476-5543 [Electronic] United States
• PMID: 31578422 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Bicarbonates
• Carbon Dioxide
• Lactic Acid

Topics

• Bicarbonates (blood)
• Blood Gas Analysis
• Carbon Dioxide (analysis)
• Electrocardiography
• Fetal Blood (chemistry)
• Fetal Monitoring
• Heart Rate, Fetal (physiology)
• Humans
• Infant, Newborn
• Infant, Newborn, Diseases (epidemiology, mortality)
• Lactic Acid (blood)
• Prospective Studies