The association between undetected small-for-gestational age and abnormal admission cardiotocography : A registry-based study
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd..
OBJECTIVE: To assess the association between undetected small-for-gestational age (SGA) fetuses and abnormal admission cardiotocography (admCTG) in a low-risk population.
DESIGN: An observational study.
SETTING: Four hospitals in Stockholm-Gotland, Sweden.
SAMPLE: A cohort of 127 461 deliveries between 1 February 2012 and 15 June 2020.
METHODS: This cohort was linked to the Swedish Neonatal Quality Register. Pregnancies were designated as high or low risk at the time of admission to the labour ward according to pre-defined risk measures. SGA was defined as a birthweight at or below the tenth centile and at or below the third centile for gestational age.
MAIN OUTCOME MEASURES: The main outcome was the proportion of undetected SGA by admCTG (normal or abnormal). The secondary outcome was a composite severe adverse neonatal outcome for fetuses born less than 6 hours after admission (Apgar score <4 at 5 minutes, hypoxic-ischaemic encephalopathy grade of 2-3, neonatal seizures and neonatal death).
RESULTS: The rate of abnormal admCTG was 4.9%. The proportion of SGA at or below the tenth centile was higher in the abnormal admCTG group than in the normal admCTG group, 18.6% versus 9.7% (odds ratio 2.1, 95% CI 1.9-2.3). Abnormal admCTG and SGA (≤10th) was associated with a more than 20-fold increased risk of an adverse outcome compared with normal admCTG and non-SGA (adjusted odds ratio 23.7, 95% CI 9.8-57.3). The latter had a risk of 1/2000 of an adverse outcome.
CONCLUSIONS: In this low-risk population, undetected SGA fetuses were more prone to having abnormal admCTG and had a substantially higher risk of severe adverse neonatal outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:130 |
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| Enthalten in: |
BJOG : an international journal of obstetrics and gynaecology - 130(2023), 11 vom: 26. Okt., Seite 1412-1420 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gyllencreutz, Erika [VerfasserIn] |
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| Links: |
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| Themen: |
Asphyxia |
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| Anmerkungen: |
Date Revised 01.09.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1111/1471-0528.17504 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356891208 |
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| 100 | 1 | |a Gyllencreutz, Erika |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The association between undetected small-for-gestational age and abnormal admission cardiotocography |b A registry-based study |
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| 500 | |a Date Revised 01.09.2023 | ||
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| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: To assess the association between undetected small-for-gestational age (SGA) fetuses and abnormal admission cardiotocography (admCTG) in a low-risk population | ||
| 520 | |a DESIGN: An observational study | ||
| 520 | |a SETTING: Four hospitals in Stockholm-Gotland, Sweden | ||
| 520 | |a SAMPLE: A cohort of 127 461 deliveries between 1 February 2012 and 15 June 2020 | ||
| 520 | |a METHODS: This cohort was linked to the Swedish Neonatal Quality Register. Pregnancies were designated as high or low risk at the time of admission to the labour ward according to pre-defined risk measures. SGA was defined as a birthweight at or below the tenth centile and at or below the third centile for gestational age | ||
| 520 | |a MAIN OUTCOME MEASURES: The main outcome was the proportion of undetected SGA by admCTG (normal or abnormal). The secondary outcome was a composite severe adverse neonatal outcome for fetuses born less than 6 hours after admission (Apgar score <4 at 5 minutes, hypoxic-ischaemic encephalopathy grade of 2-3, neonatal seizures and neonatal death) | ||
| 520 | |a RESULTS: The rate of abnormal admCTG was 4.9%. The proportion of SGA at or below the tenth centile was higher in the abnormal admCTG group than in the normal admCTG group, 18.6% versus 9.7% (odds ratio 2.1, 95% CI 1.9-2.3). Abnormal admCTG and SGA (≤10th) was associated with a more than 20-fold increased risk of an adverse outcome compared with normal admCTG and non-SGA (adjusted odds ratio 23.7, 95% CI 9.8-57.3). The latter had a risk of 1/2000 of an adverse outcome | ||
| 520 | |a CONCLUSIONS: In this low-risk population, undetected SGA fetuses were more prone to having abnormal admCTG and had a substantially higher risk of severe adverse neonatal outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a asphyxia | |
| 650 | 4 | |a cardiotocography | |
| 650 | 4 | |a diagnosis | |
| 650 | 4 | |a fetal growth restriction | |
| 650 | 4 | |a fetal hypoxia | |
| 650 | 4 | |a infant | |
| 650 | 4 | |a screening | |
| 650 | 4 | |a small for gestational age | |
| 700 | 1 | |a Varli, Ingela Hulthén |e verfasserin |4 aut | |
| 700 | 1 | |a Johansson, Kari |e verfasserin |4 aut | |
| 700 | 1 | |a Lindqvist, Pelle G |e verfasserin |4 aut | |
| 700 | 1 | |a Holzmann, Malin |e verfasserin |4 aut | |
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