Key result
Absence of fetal heart rate reactivity was significantly associated with increased odds of death (OR 3.45; 95% CI 1.22-9.47; p=0.02) and severe intraventricular hemorrhage in ELBW infants.
Why the study?
Does the absence of fetal heart rate reactivity predict death and severe neurological morbidity in extremely low birth weight infants?
Observational (n=96)
No
Does the absence of fetal heart rate reactivity predict death and severe neurological morbidity in extremely low birth weight infants?
Absence of fetal heart rate reactivity in extremely low birth weight infants is a significant predictor of short-term mortality and severe intraventricular hemorrhage.
Should not yet guide ELBW delivery decisions; hypothesis-generating for reactivity as a prognostic marker.
OBJECTIVE: To determine the correlation between specific fetal heart rate (FHR) abnormalities and the incidence of death, severe (grade 3-4) intraventricular hemorrhage (IVH) and periventricular echogenicity (PVE) in extremely low birth weight infants (ELBW) within the first 4 days after birth. METHODS: The study included live-born ELBW infants ≤ 30 weeks' gestation who were born in 2000-2007 at Kaplan Medical Center, Rehovot, Israel, and, who had FHR monitoring during the 24 h before delivery and cranial ultrasound during the first 4 days of life. FHR pattern was analyzed for the presence of baseline rate, reactivity, variability and decelerations. RESULTS: 96 infants with mean birth weight 757 ± 150 g and mean gestational age 25.8 ± 1.5 weeks were included. By 4 days of life, 23/96 (24%) died, 17/96 (18%) developed severe IVH and 31/96 (32%) had PVE. Absence of reactivity was significantly associated with increase in both death (p = 0.02, OR 3.45, 95% CI: 1.22-9.47 and severe IVH (p = 0.029, OR 3.33, 95% CI: 1.25-10) but not with PVE. Other FHR parameters were not associated with adverse outcome. CONCLUSION: These results suggest that FHR reactivity may be of value in predicting short-term outcome in ELBW infants. This may be helpful in counseling parents with imminent extremely preterm birth.
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Eventov‐Friedman et al. (2011) conducted an observational in Extremely low birth weight infants (n=96). Absence of fetal heart rate reactivity vs. Presence of fetal heart rate reactivity was evaluated on Death within the first 4 days after birth (OR 3.45, 95% CI 1.22-9.47, p=0.02). Absence of fetal heart rate reactivity was significantly associated with increased odds of death (OR 3.45; 95% CI 1.22-9.47; p=0.02) and severe intraventricular hemorrhage in ELBW infants.
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