TY - JOUR
T1 - Effect of Growth Restriction on Fetal Heart Rate Patterns in the Second Stage of Labor
AU - Epplin, Kristina A.
AU - Tuuli, Methodius G.
AU - Odibo, Anthony O.
AU - Roehl, Kimberly A.
AU - Macones, George A.
AU - Cahill, Alison G.
N1 - Publisher Copyright:
© 2015 by Thieme Medical Publishers, Inc.
PY - 2015/1/21
Y1 - 2015/1/21
N2 - ObjectiveWe aimed to estimate the effect of intrauterine growth restriction (IUGR) on electronic fetal monitoring (EFM) patterns in the second stage of labor. Study DesignWe performed a 5-year retrospective cohort study of consecutive singleton, nonanomalous, term gestations. We compared IUGR infants, those with a birth weight less than the 10th percentile, with non-IUGR infants, those greater than or equal to the 10th percentile. Our primary outcome was the EFM patterns in the 30 minutes before delivery. A secondary analysis was performed excluding infants with composite morbidity. Logistic regression was used to adjust for body mass index, race, nulliparity, induction, and protracted labor. ResultsOut of the 5,388 infants, 652 (12.1%) were IUGR. IUGR fetuses had less accelerations (29.0 vs. 35.9%, p < 0.01), even among apparently normal infants (29.0 vs. 36.4%, p < 0.01). IUGR fetuses had a higher risk of decelerations, and in all, IUGR accounted for 6% of late decelerations (attributable risk 0.06, 95% confidence interval 0.02-0.10). There was no significant association between IUGR and bradycardia or minimal variability. ConclusionGrowth restriction at term confers an increased risk of late decelerations, even in the absence of neonatal morbidity. EFM patterns may require different interpretations based on a priori risk and clinical factors.
AB - ObjectiveWe aimed to estimate the effect of intrauterine growth restriction (IUGR) on electronic fetal monitoring (EFM) patterns in the second stage of labor. Study DesignWe performed a 5-year retrospective cohort study of consecutive singleton, nonanomalous, term gestations. We compared IUGR infants, those with a birth weight less than the 10th percentile, with non-IUGR infants, those greater than or equal to the 10th percentile. Our primary outcome was the EFM patterns in the 30 minutes before delivery. A secondary analysis was performed excluding infants with composite morbidity. Logistic regression was used to adjust for body mass index, race, nulliparity, induction, and protracted labor. ResultsOut of the 5,388 infants, 652 (12.1%) were IUGR. IUGR fetuses had less accelerations (29.0 vs. 35.9%, p < 0.01), even among apparently normal infants (29.0 vs. 36.4%, p < 0.01). IUGR fetuses had a higher risk of decelerations, and in all, IUGR accounted for 6% of late decelerations (attributable risk 0.06, 95% confidence interval 0.02-0.10). There was no significant association between IUGR and bradycardia or minimal variability. ConclusionGrowth restriction at term confers an increased risk of late decelerations, even in the absence of neonatal morbidity. EFM patterns may require different interpretations based on a priori risk and clinical factors.
KW - IUGR
KW - fetal heart rate
KW - fetal monitoring
KW - growth restriction
UR - http://www.scopus.com/inward/record.url?scp=84938062528&partnerID=8YFLogxK
U2 - 10.1055/s-0034-1543954
DO - 10.1055/s-0034-1543954
M3 - Article
C2 - 25607225
AN - SCOPUS:84938062528
SN - 0735-1631
VL - 32
SP - 873
EP - 878
JO - American journal of perinatology
JF - American journal of perinatology
IS - 9
ER -