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

Journal of Perinatology volume 40, pages 56–62 (2020)Cite this article

Subjects

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.

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Funding

Funding

This work was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (R01HD061619-01, PI Cahill). Dr Cahill was a Robert Wood Johnson Foundation Faculty Physician Scholar, which partially supported this work. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of the NIH or Robert Wood Johnson Foundation.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA

    Brock Polnaszek, Julia D. López, Reece Clark & Nandini Raghuraman

  2. The University of Texas at Austin Dell Medical School, Austin, TX, USA

    George A. Macones & Alison G. Cahill

Authors
  1. Brock Polnaszek
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  2. Julia D. López
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  3. Reece Clark
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  4. Nandini Raghuraman
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  5. George A. Macones
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  6. Alison G. Cahill
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Corresponding author

Correspondence to Brock Polnaszek.

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Presented at the 39th Annual Scientific Meeting of the Society for Maternal Fetal Medicine, February 15th, 2019 in Las Vegas, Nevada.

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Polnaszek, B., López, J.D., Clark, R. et al. Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas. J Perinatol 40, 56–62 (2020). https://doi.org/10.1038/s41372-019-0520-9

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