Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes.

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  • Additional Information
    • Affiliation:
      Division of Maternal–Fetal Medicine, Department of Obstetrics & Gynecology, Beaumont Hospital, Royal Oak, MI, USA
      William Beaumont School of Medicine, Oakland University, Rochester Hills, MI, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Objective: The objective of this study is to evaluate the associations of electronic fetal heart rate monitoring (EFM) patterns and adverse neonatal outcomes Study design: From 2013 to 2016; 12,067 term, singleton deliveries in labor ≥2 h with abnormal EFM defined as absent accelerations, variable, late or prolonged decelerations, tachycardia, bradycardia, or minimal variability were analyzed as any documentation during labor, in first hour and last hour of labor. Outcomes were composite neonatal adverse outcomes, neonatal intensive care unit (NICU) admission, neonatal hypoxia, neonatal hypoglycemia, umbilical artery pH, and base excess. Independent associations were ascertained using regression analysis. Results: Significant independent associations occurred between any abnormal EFM during the last hour and five adverse neonatal outcomes; between abnormal EFM at any time and one adverse neonatal outcome while there was none with the first hour of labor. In the last hour, accelerations had significant negative associations with three adverse neonatal outcomes, while prolonged decelerations, late decelerations, tachycardia, and bradycardia had significant positive associations with three adverse neonatal outcomes. Throughout labor, increasing accelerations events were significantly negatively correlated with all adverse neonatal outcomes, while increasing frequency of late, variable, and prolonged decelerations were positively associated with five adverse neonatal outcomes. Hierarchical analysis showed that bradycardia/tachycardia contributed only 0.8%, while all EFM periodic changes contributed 1%; the addition of the frequencies of abnormal EFM events contributed 0.6% to the variance in umbilical artery pH and base excess. Conclusions: Terminal EFM patterns are independently associated with neonatal outcomes. Accelerations are protective of adverse neonatal outcomes. Increasing frequency of EFM patterns overtime contributes to neonatal outcome.
    • Journal Subset:
      Biomedical; Europe; UK & Ireland
    • ISSN:
      1476-7058
    • MEDLINE Info:
      PMID: NLM29621921 NLM UID: 101136916
    • Publication Date:
      20191122
    • Publication Date:
      20200201
    • Accession Number:
      http://dx.doi.org/10.1080/14767058.2018.1456523
    • Accession Number:
      136807320
  • Citations
    • ABNT:
      OGUNYEMI, D. et al. Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†. Journal of Maternal-Fetal & Neonatal Medicine, [s. l.], v. 32, n. 18, p. 3115–3124, 2019. DOI 10.1080/14767058.2018.1456523. Disponível em: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ccm&AN=136807320&authtype=sso&custid=s5834912. Acesso em: 11 jul. 2020.
    • AMA:
      Ogunyemi D, Friedman P, Madan I, Jovanovski A, Sweatman B. Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†. Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(18):3115-3124. doi:10.1080/14767058.2018.1456523.
    • AMA11:
      Ogunyemi D, Friedman P, Madan I, Jovanovski A, Sweatman B. Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†. Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(18):3115-3124. doi:10.1080/14767058.2018.1456523
    • APA:
      Ogunyemi, D., Friedman, P., Madan, I., Jovanovski, A., & Sweatman, B. (2019). Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†. Journal of Maternal-Fetal & Neonatal Medicine, 32(18), 3115–3124. https://doi.org/10.1080/14767058.2018.1456523
    • Chicago/Turabian: Author-Date:
      Ogunyemi, Dotun, Perry Friedman, Ichchha Madan, Andrew Jovanovski, and Brittany Sweatman. 2019. “Temporal and Quantitative Associations of Electronic Fetal Heart Rate Monitoring Patterns and Neonatal Outcomes†.” Journal of Maternal-Fetal & Neonatal Medicine 32 (18): 3115–24. doi:10.1080/14767058.2018.1456523.
    • Harvard:
      Ogunyemi, D. et al. (2019) ‘Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†’, Journal of Maternal-Fetal & Neonatal Medicine, 32(18), pp. 3115–3124. doi: 10.1080/14767058.2018.1456523.
    • Harvard: Australian:
      Ogunyemi, D, Friedman, P, Madan, I, Jovanovski, A & Sweatman, B 2019, ‘Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†’, Journal of Maternal-Fetal & Neonatal Medicine, vol. 32, no. 18, pp. 3115–3124, viewed 11 July 2020, .
    • MLA:
      Ogunyemi, Dotun, et al. “Temporal and Quantitative Associations of Electronic Fetal Heart Rate Monitoring Patterns and Neonatal Outcomes†.” Journal of Maternal-Fetal & Neonatal Medicine, vol. 32, no. 18, Sept. 2019, pp. 3115–3124. EBSCOhost, doi:10.1080/14767058.2018.1456523.
    • Chicago/Turabian: Humanities:
      Ogunyemi, Dotun, Perry Friedman, Ichchha Madan, Andrew Jovanovski, and Brittany Sweatman. “Temporal and Quantitative Associations of Electronic Fetal Heart Rate Monitoring Patterns and Neonatal Outcomes†.” Journal of Maternal-Fetal & Neonatal Medicine 32, no. 18 (September 15, 2019): 3115–24. doi:10.1080/14767058.2018.1456523.
    • Vancouver/ICMJE:
      Ogunyemi D, Friedman P, Madan I, Jovanovski A, Sweatman B. Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†. Journal of Maternal-Fetal & Neonatal Medicine [Internet]. 2019 Sep 15 [cited 2020 Jul 11];32(18):3115–24. Available from: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ccm&AN=136807320&authtype=sso&custid=s5834912