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Sporadic accelerations during labor strongly indicate normal pH, whereas periodic accelerations do not: a case-control study

Ekengård, Frida LU ; Cardell, Monika LU and Herbst, Andreas LU (2023) In Journal of Maternal-Fetal & Neonatal Medicine 36(1).
Abstract
Purpose
To determine the association between the occurrence of sporadic and periodic fetal heart rate accelerations during labor and acidemia at birth.
Materials and methods
This is a case–control study of fetal heart rate patterns from 364 neonates with acidemia at birth (cord blood pH Results
During the first stage, ≥2 sporadic accelerations were present in 16% of cases and 78% of controls; OR for acidemia (compared to 0–1 accelerations) 0.05 (0.02–0.10). In the second stage, the corresponding rates were 13% and 60%, OR 0.09 (0.06–0.14). Isolated periodic accelerations were infrequent. A weak negative association between ≥2 periodic accelerations and acidemia (compared with 0–1 accelerations) was found in the second... (More)
Purpose
To determine the association between the occurrence of sporadic and periodic fetal heart rate accelerations during labor and acidemia at birth.
Materials and methods
This is a case–control study of fetal heart rate patterns from 364 neonates with acidemia at birth (cord blood pH Results
During the first stage, ≥2 sporadic accelerations were present in 16% of cases and 78% of controls; OR for acidemia (compared to 0–1 accelerations) 0.05 (0.02–0.10). In the second stage, the corresponding rates were 13% and 60%, OR 0.09 (0.06–0.14). Isolated periodic accelerations were infrequent. A weak negative association between ≥2 periodic accelerations and acidemia (compared with 0–1 accelerations) was found in the second stage, OR 0.51 (0.30–0.86), but was not significant in the first stage, OR 0.24 (0.04–1.4). Even among fetuses with normal fetal heart rate variability (5–25 beats per minute) the occurrence of less than two sporadic accelerations was associated with an increased risk of acidemia, OR 10.3 (7.2–14.8).
Conclusions
Sporadic accelerations indicate a very low probability of acidosis but are absent in 40% of fetuses with normal pH during a 30–60 min second-stage recording. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Maternal-Fetal & Neonatal Medicine
volume
36
issue
1
publisher
Taylor & Francis
external identifiers
  • pmid:36521850
  • scopus:85144223911
ISSN
1476-7058
DOI
10.1080/14767058.2022.2157717
language
English
LU publication?
yes
id
7798456c-d934-4cf5-81a9-4f31267814bf
date added to LUP
2023-01-02 07:59:35
date last changed
2023-10-26 15:03:56
@article{7798456c-d934-4cf5-81a9-4f31267814bf,
  abstract     = {{Purpose<br/>To  determine the association between the occurrence of sporadic and periodic fetal heart rate accelerations during labor and acidemia at birth.<br/>Materials and methods<br/>This is a case–control study of fetal heart rate patterns from 364 neonates with acidemia at birth (cord blood pH Results<br/>During the first stage, ≥2 sporadic accelerations were present in 16% of cases and 78% of controls; OR for acidemia (compared to 0–1 accelerations) 0.05 (0.02–0.10). In the second stage, the corresponding rates were 13% and 60%, OR 0.09 (0.06–0.14). Isolated periodic accelerations were infrequent. A weak negative association between ≥2 periodic accelerations and acidemia (compared with 0–1 accelerations) was found in the second stage, OR 0.51 (0.30–0.86), but was not significant in the first stage, OR 0.24 (0.04–1.4). Even among fetuses with normal fetal heart rate variability (5–25 beats per minute) the occurrence of less than two sporadic accelerations was associated with an increased risk of acidemia, OR 10.3 (7.2–14.8).<br/>Conclusions<br/>Sporadic accelerations indicate a very low probability of acidosis but are absent in 40% of fetuses with normal pH during a 30–60 min second-stage recording.}},
  author       = {{Ekengård, Frida and Cardell, Monika and Herbst, Andreas}},
  issn         = {{1476-7058}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Journal of Maternal-Fetal & Neonatal Medicine}},
  title        = {{Sporadic accelerations during labor strongly indicate normal pH, whereas periodic accelerations do not: a case-control study}},
  url          = {{http://dx.doi.org/10.1080/14767058.2022.2157717}},
  doi          = {{10.1080/14767058.2022.2157717}},
  volume       = {{36}},
  year         = {{2023}},
}