The provided text contains only the editorial board and publication information for the American Journal of Perinatology and does not include any clinical study data.
Are specific fetal heart rate tracing patterns associated with composite adverse neonatal outcomes in preterm deliveries at 320/7 to 366/7 weeks?
Minimal variability and severe variable decelerations in fetal heart rate tracings are associated with increased adverse neonatal outcomes in late preterm deliveries.
Abstract The objective of this study is to determine if patterns of fetal heart rate tracings (FHRT) were associated with an increased rate of composite adverse neonatal outcomes (CANO) among preterm deliveries at 320/7 to 366/7 weeks. This was a retrospective review of intrapartum FHRT between 20 and 120 minutes before birth, among nonanomalous singletons delivered at 320/7 to 366/7 weeks. The study was conducted at a Level IV maternal center during a consecutive 15-month period. Obstetricians reviewing FHRT were blinded to the maternal characteristics, intrapartum course, and neonatal outcomes. FHRT patterns were categorized based on time spent in the final 2 hours before delivery ( 6 hours, umbilical artery pH < 7.00, bronchopulmonary dysplasia, interventricular hemorrhage, necrotizing enterocolitis, neonatal seizures, neonatal confirmed sepsis, hypoxic ischemic encephalopathy, birth injury, meconium aspiration syndrome, or neonatal death. Of 5,160 patients, 672 (13%) met the inclusion criteria. CANO occurred in 57 (8.5%) newborns. Overall, FHRT patterns that differed significantly between those without versus with CANO included minimal variability (8.8 vs. 19.3%, p = 0.01, PLR = 2.2 positive likelihood ratio, PPTP 17% positive posttest probability), moderate variability (76.4 vs. 52.6%, p < 0.001, NLR = 2.01 negative likelihood ratio, NPTP 15.7% negative posttest probability), accelerations (58.4 vs. 40.4%, p = 0.009, NLR = 1.43, NPTP = 11.7%), and severe variable decelerations (3.5% p = 0.003, PLR = 10.79, PPTP = 50.1%). Category III FHRT pattern was also associated with an increased posttest probably of CANO (0.3 vs. 1.8%, p = 0.12, PLR = 5.39, PPTP = 27%). While moderate variability and accelerations were associated with significantly lower likelihood of CANO among newborns delivered at 320/7 to 366/7 weeks, minimal variability and severe variable decelerations were significantly more common in preterm newborns with CANO.
Cortes et al. (Tue,) reported a other. The provided text contains only the editorial board and publication information for the American Journal of Perinatology and does not include any clinical study data.