Objectives: To assess labour characteristics in relation to the occurrence of Composite Adverse neonatal Outcome (CAO) within a cohort of fetuses with metabolic acidaemia. Design: Retrospective cohort study. Setting: Three Italian tertiary maternity units. Population: 431 neonates born with acidaemia ≥36 weeks. Methods: Intrapartum CTG traces were assigned to one of these four types of labour hypoxia: acute, subacute, gradually evolving and chronic hypoxia. The presence of CAO was defined by the occurrence of at least one of the following: Sarnat Score grade ≥2, seizures, hypothermia and death <7 days from birth. Main outcome measures: To compare the type of hypoxia on the intrapartum CTG traces among the acidaemic neonates with and without CAO. Results: The occurrence of a CAO was recorded in 15.1% of neonates. At logistic regression analysis, the duration of the hypoxia was the only parameter associated with CAO in the case of an acute or subacute pattern (odds ratio [OR] 1.3; 95% CI 1.02–1.6 and OR 1.04; 95% CI 1.0–1.1, respectively), whereas both the duration of the hypoxic insult and the time from PROM to delivery were associated with CAO in those with a gradually evolving pattern (OR 1.13; 95% CI 1.01–1.3 and OR 1.04; 95% CI 1.0–1.7, respectively). The incidence of CAO was higher in fetuses with chronic antepartum hypoxia than in those showing CTG features of intrapartum hypoxia (64.7 vs. 13.0%; P < 0.001). Conclusions: The frequency of CAO seems related to the duration and the type of the hypoxic injury, being higher in fetuses showing CTG features of antepartum chronic hypoxia.

Short-term morbidity and types of intrapartum hypoxia in the newborn with metabolic acidaemia: a retrospective cohort study / di Pasquo, E.; Commare, A.; Masturzo, B.; Paolucci, S.; Cromi, A.; Montersino, B.; Germano, C. M.; Attini, R.; Perrone, S.; Pisani, F.; Dall'Asta, A.; Fieni, S.; Frusca, T.; Ghi, T.. - In: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. - ISSN 1470-0328. - (2022). [10.1111/1471-0528.17133]

Short-term morbidity and types of intrapartum hypoxia in the newborn with metabolic acidaemia: a retrospective cohort study

Commare A.;Pisani F.;Dall'Asta A.;Fieni S.;Frusca T.;Ghi T.
2022

Abstract

Objectives: To assess labour characteristics in relation to the occurrence of Composite Adverse neonatal Outcome (CAO) within a cohort of fetuses with metabolic acidaemia. Design: Retrospective cohort study. Setting: Three Italian tertiary maternity units. Population: 431 neonates born with acidaemia ≥36 weeks. Methods: Intrapartum CTG traces were assigned to one of these four types of labour hypoxia: acute, subacute, gradually evolving and chronic hypoxia. The presence of CAO was defined by the occurrence of at least one of the following: Sarnat Score grade ≥2, seizures, hypothermia and death <7 days from birth. Main outcome measures: To compare the type of hypoxia on the intrapartum CTG traces among the acidaemic neonates with and without CAO. Results: The occurrence of a CAO was recorded in 15.1% of neonates. At logistic regression analysis, the duration of the hypoxia was the only parameter associated with CAO in the case of an acute or subacute pattern (odds ratio [OR] 1.3; 95% CI 1.02–1.6 and OR 1.04; 95% CI 1.0–1.1, respectively), whereas both the duration of the hypoxic insult and the time from PROM to delivery were associated with CAO in those with a gradually evolving pattern (OR 1.13; 95% CI 1.01–1.3 and OR 1.04; 95% CI 1.0–1.7, respectively). The incidence of CAO was higher in fetuses with chronic antepartum hypoxia than in those showing CTG features of intrapartum hypoxia (64.7 vs. 13.0%; P < 0.001). Conclusions: The frequency of CAO seems related to the duration and the type of the hypoxic injury, being higher in fetuses showing CTG features of antepartum chronic hypoxia.
Short-term morbidity and types of intrapartum hypoxia in the newborn with metabolic acidaemia: a retrospective cohort study / di Pasquo, E.; Commare, A.; Masturzo, B.; Paolucci, S.; Cromi, A.; Montersino, B.; Germano, C. M.; Attini, R.; Perrone, S.; Pisani, F.; Dall'Asta, A.; Fieni, S.; Frusca, T.; Ghi, T.. - In: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. - ISSN 1470-0328. - (2022). [10.1111/1471-0528.17133]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2921768
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