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Factors Associated with Adverse Neonatal Outcomes in Category II Intrapartum Fetal Heart Rate Tracings

Ninlapa Pruksanusak MD 1 , Rattanawadee Duangchan MD 1 , Chitkasaem Suwanrath MD, M.Med.Sci 1

Affiliation : 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand


Objective : To evaluate the risk factors associated with adverse neonatal outcomes in category II intrapartum fetal heart rate (FHR) tracing
Materials and Methods : This was a retrospective study, conducted at Songklanagarind Hospital from April 2014 to December 2015. All pregnant women with gestational aged 35 to 42 weeks and category II intrapartum FHR tracing were included to determine adverse neonatal outcomes and their associated risk factors. Statistical analysis was performed using the R software program, utilizing the Chi square test, Fisher exact test to compare between the groups. Multiple logistic regression was used to investigate the independent factors associated with adverse neonatal outcomes.
Results : A total of 248 pregnant women were enrolled. The cesarean section rate was 88.7%. Seven-teen (6.8 %) neonates had adverse neonatal outcomes, but no neonatal death. The independent factors associated with adverse neonatal outcomes were maternal infection (OR, 54.04; 95%CI 4.29-680.74), thick meconium stained amniotic fluid (OR, 6.63; 95%CI 1.9-23.13) and moderate to severe late deceleration (OR, 3.95; 95%CI 1.13-13.79).
Conclusion : Category II intrapartum FHR tracings, combined with maternal infection or meconium stained amniotic fluid had significant effect on adverse neonatal outcomes.

Keywords : Intrapartum fetal heart rate, Tracing, Category II


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