Work

Fetal Heart Rate Tracings and Adverse Outcomes among Term Small versus Appropriate for Gestational Age

Year: 2025

Type: article

Abstract: Objective: This study aimed to compare the patterns of fetal heart rate tracings (FHRTs), and outcomes among individuals with small (birth weight [BW] <10% for gestational age [GA]; SGA) versus appropriate (BW at 10-89% for GA; AGA) newborns at term (≥37.0 weeks). Study Design: Our retrospective cohort study included consecutive deliveries over 15 months at a level IV center. FHRTs were reviewed by obstetricians blinded to maternal and neonatal outcomes. The inclusion criteria were non-anomalous singletons, cataloged as SGA or AGA birth weight using Alexander et al's nomogram. In 20-minute segments, the last 120 minutes of tracing were characterized. Rates of cesarean delivery (CD) and composite neonatal adverse outcomes (CNAOs) were compared. Results: = 0.95). Conclusion: In our cohort of those with fetal monitoring prior to delivery at ≥37 weeks, persistent category II FHRT at the end of labor was significantly more common in SGA compared to AGA neonates; however, composite neonatal morbidity did not differ between the two groups. Our analysis provides data for shared decision-making that among SGA newborns, abnormalities of FHRT are not linked with adverse outcomes. Key Points: · There were no differences in FHRT baseline, variability, or accelerations between AGA and SGA.. · SGA was more likely to have prolonged decelerations and recurrent decelerations with ≥50% of contractions.. · Persistent category II FHRT before delivery is significantly more common with SGA than AGA.. · FHRT abnormalities, however, were not associated with CD for non-reassuring FHRT, or adverse outcomes..

Source: American Journal of Perinatology

DOI: 10.1055/a-2729-1189