BACKGROUND: To evaluate the validity of fetal heart rate monitoring during the last hour prior to birth, as a predictor of long term neurodevelopmental outcome of very low birth weight infants. METHODS: A total of 111 very low birth weight infants were included in the study. Fetal heart rate tracings were obtained during the last hour prior to delivery. A perinatologist, blinded to the neonatal outcome, evaluated the tracings and divided them into three groups: reassuring, nonreassuring, and pathological. Neurodevelopmental status was evaluated at age 2 years. The relationship between fetal heart rate monitoring results and the neurodevelopmental outcome at 2 years of age was assessed with a chi-square test and the Student's t-test. RESULTS: At 2 years of age 97 (87.4\%) of the children had normal neurodevelopmental function, while 14 (12.6\%) had variable degrees of neurodevelopmental impairment. The fetal heart rate monitoring results were classified as reassuring (normal) in 35 cases (31.5\%), nonreassuring in 56 cases (50.5\%), and pathological in 20 cases (18.0\%). Both normal and pathological fetal heart rate patterns were associated with similar incidence of abnormal neurodevelopmental outcome, 14.3\% and 15.0\% of cases, respectively (p=0.778). Pathological fetal heart rate patterns as a predictor of neurodevelopmental outcome had a sensitivity of 27\%, specificity of 74\%, positive predictive value of 15\%, and negative predictive value of 86\%. CONCLUSION: Electronic fetal heart rate monitoring prior to delivery is not a reliable tool for the prediction of neurodevelopmental impairment in premature infants of very low birth weight, at 2 years of age.
%0 Journal Article
%1 Nisenblat2006
%A Nisenblat, Vicki
%A Alon, Eran
%A Barak, Shlomi
%A Gonen, Ron
%A Bader, David
%A Ohel, Gonen
%D 2006
%J Acta Obstet Gynecol Scand
%K Cerebral Palsy; Child, Preschool; Developmental Disabilities; Female; Fetal Monitoring; Heart Rate, Fetal; Humans; Infant, Newborn; Very Low Birth Weight; Labor, Obstetric; Male; Predictive Value of Tests; Pregnancy; Sensitivity and Specificity
%N 7
%P 792--796
%R 10.1080/00016340500501707
%T Fetal heart rate patterns and neurodevelopmental outcome in very low birth weight infants.
%U http://dx.doi.org/10.1080/00016340500501707
%V 85
%X BACKGROUND: To evaluate the validity of fetal heart rate monitoring during the last hour prior to birth, as a predictor of long term neurodevelopmental outcome of very low birth weight infants. METHODS: A total of 111 very low birth weight infants were included in the study. Fetal heart rate tracings were obtained during the last hour prior to delivery. A perinatologist, blinded to the neonatal outcome, evaluated the tracings and divided them into three groups: reassuring, nonreassuring, and pathological. Neurodevelopmental status was evaluated at age 2 years. The relationship between fetal heart rate monitoring results and the neurodevelopmental outcome at 2 years of age was assessed with a chi-square test and the Student's t-test. RESULTS: At 2 years of age 97 (87.4\%) of the children had normal neurodevelopmental function, while 14 (12.6\%) had variable degrees of neurodevelopmental impairment. The fetal heart rate monitoring results were classified as reassuring (normal) in 35 cases (31.5\%), nonreassuring in 56 cases (50.5\%), and pathological in 20 cases (18.0\%). Both normal and pathological fetal heart rate patterns were associated with similar incidence of abnormal neurodevelopmental outcome, 14.3\% and 15.0\% of cases, respectively (p=0.778). Pathological fetal heart rate patterns as a predictor of neurodevelopmental outcome had a sensitivity of 27\%, specificity of 74\%, positive predictive value of 15\%, and negative predictive value of 86\%. CONCLUSION: Electronic fetal heart rate monitoring prior to delivery is not a reliable tool for the prediction of neurodevelopmental impairment in premature infants of very low birth weight, at 2 years of age.
@article{Nisenblat2006,
abstract = {BACKGROUND: To evaluate the validity of fetal heart rate monitoring during the last hour prior to birth, as a predictor of long term neurodevelopmental outcome of very low birth weight infants. METHODS: A total of 111 very low birth weight infants were included in the study. Fetal heart rate tracings were obtained during the last hour prior to delivery. A perinatologist, blinded to the neonatal outcome, evaluated the tracings and divided them into three groups: reassuring, nonreassuring, and pathological. Neurodevelopmental status was evaluated at age 2 years. The relationship between fetal heart rate monitoring results and the neurodevelopmental outcome at 2 years of age was assessed with a chi-square test and the Student's t-test. RESULTS: At 2 years of age 97 (87.4\%) of the children had normal neurodevelopmental function, while 14 (12.6\%) had variable degrees of neurodevelopmental impairment. The fetal heart rate monitoring results were classified as reassuring (normal) in 35 cases (31.5\%), nonreassuring in 56 cases (50.5\%), and pathological in 20 cases (18.0\%). Both normal and pathological fetal heart rate patterns were associated with similar incidence of abnormal neurodevelopmental outcome, 14.3\% and 15.0\% of cases, respectively (p=0.778). Pathological fetal heart rate patterns as a predictor of neurodevelopmental outcome had a sensitivity of 27\%, specificity of 74\%, positive predictive value of 15\%, and negative predictive value of 86\%. CONCLUSION: Electronic fetal heart rate monitoring prior to delivery is not a reliable tool for the prediction of neurodevelopmental impairment in premature infants of very low birth weight, at 2 years of age.},
added-at = {2014-07-19T20:55:58.000+0200},
author = {Nisenblat, Vicki and Alon, Eran and Barak, Shlomi and Gonen, Ron and Bader, David and Ohel, Gonen},
biburl = {https://www.bibsonomy.org/bibtex/2b9f0f1d4e4fff2aca3bba08fc39407a3/ar0berts},
doi = {10.1080/00016340500501707},
groups = {public},
interhash = {fd98424ecd05b7a9bd794fb48a165ecc},
intrahash = {b9f0f1d4e4fff2aca3bba08fc39407a3},
journal = {Acta Obstet Gynecol Scand},
keywords = {Cerebral Palsy; Child, Preschool; Developmental Disabilities; Female; Fetal Monitoring; Heart Rate, Fetal; Humans; Infant, Newborn; Very Low Birth Weight; Labor, Obstetric; Male; Predictive Value of Tests; Pregnancy; Sensitivity and Specificity},
number = 7,
pages = {792--796},
pii = {744941361},
pmid = {16817075},
timestamp = {2014-07-19T20:55:58.000+0200},
title = {Fetal heart rate patterns and neurodevelopmental outcome in very low birth weight infants.},
url = {http://dx.doi.org/10.1080/00016340500501707},
username = {ar0berts},
volume = 85,
year = 2006
}