Preterm cesarean delivery for nonreassuring fetal heart rate: neonatal and neurologic morbidity

Obstetrics and Gynecology
Hector Mendez-FigueroaDwight J Rouse

Abstract

To compare the rates of neonatal morbidity and cerebral palsy among preterm neonates (less than 37 weeks of gestation) delivered by cesarean for a nonreassuring fetal heart rate (FHR) tracing compared with those who did not. This was a secondary analysis of a multicenter randomized trial of MgSO4 for the prevention of cerebral palsy. Newborns of women delivered by cesarean delivery for nonreassuring FHR were compared with a control group composed of the offspring of women who labored for 2 hours or longer but did not undergo cesarean delivery for nonreassuring FHR regardless of the mode of delivery. Using multivariable analysis to adjust for potential confounders, our objective was to compare two outcomes: 1) composite neonatal morbidity (Apgar score 3 or less at 5 minutes, seizure, sepsis, necrotizing enterocolitis grade II or III, intraventricular hemorrhage grade III or IV, or death before discharge) and 2) neurologic injury (cerebral palsy) at 2 years or more of corrected age between the groups. Of the 1,291 preterm neonates who met the inclusion criteria, 177 (14%) were delivered by cesarean for nonreassuring FHR compared with 1,114 (86%) in the control group. Composite neonatal morbidity was similar between the groups (30...Continue Reading

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Citations

Nov 9, 2018·Frontiers in Physiology·Thâmila Kamila de Souza MedeirosLuciana Aparecida Campos
Jan 10, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Mikko TarvonenKari Teramo

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