Obstetric Anesthesia

Fetal and Neonatal Considerations

Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States

Chen H-Y, Chauhan SP, Ananth CV, et al (Univ of Wisconsin–Madison; Eastern Virginia Med School, Norfolk; Columbia Univ, NY; et al) Am J Obstet Gynecol 204:491.e1-491.e10, 2011^§

Abstract

Objective

To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity.

Study Design

We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders.

Results

In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores <4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65).

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