Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization

<i>Background and Objectives:</i> Electronic fetal heart rate monitoring is mandatory for preterm labor. Moderate to late preterm neonates have an increased risk of overall morbidity, neonatal intensive care (NICU) admission, and consequently, medication use. The outcome of preterm neona...

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Main Authors: Jelena Sabljić, Klara Čogelja, Edita Runjić, Blagoja Markoski, Marijana Barbača, Toni Modrić, Boris Bačić
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1171
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author Jelena Sabljić
Klara Čogelja
Edita Runjić
Blagoja Markoski
Marijana Barbača
Toni Modrić
Boris Bačić
author_facet Jelena Sabljić
Klara Čogelja
Edita Runjić
Blagoja Markoski
Marijana Barbača
Toni Modrić
Boris Bačić
author_sort Jelena Sabljić
collection DOAJ
description <i>Background and Objectives:</i> Electronic fetal heart rate monitoring is mandatory for preterm labor. Moderate to late preterm neonates have an increased risk of overall morbidity, neonatal intensive care (NICU) admission, and consequently, medication use. The outcome of preterm neonates > 32 weeks of gestation in relation to three-tiered fetal heart rate (FHR) categorization was analyzed. <i>Materials and Methods:</i> This was a single-center, retrospective case-control study conducted from January 2021 to December 2023. The study included 25 FGR and 131 control cases born from 33 to 36 6/7 gestational weeks. Outcome was defined as the need for assistance after birth in first 15 min of life, respiratory outcome, and first day dopamine use and fresh frozen plasma transfusion. Maternal characteristics as risk factors for non-normal categories within three-tiered FHR categorization were also analyzed. <i>Results:</i> There was no significant difference in neonatal outcome among groups, except significantly lower 1 min APGAR and longer LOS in the FGR group. An increasing category within the three-tiered FHR categorization positively correlated with the need for assistance after birth, respiratory outcome, dopamine use, fresh frozen plasma transfusion, and length of hospital stay. Negative correlations were revealed between the increasing category within the three-tiered FHR categorization and first and fifth minute APGAR scores. Oligohydramnios and male sex were risk factors for non-normal categories within three-tiered FHR categorization. The correlation was tested using the Spearman correlation coefficient. A logistic regression model was employed to identify maternal risk factors for the non-normal category within three-tiered FHR categorization. All differences were statistically significant (<i>p</i> < 0.05). <i>Conclusions:</i> The increasing category within three-tiered FHR categorization may alert neonatologists to be highly suspicious of RDS, respiratory support, dopamine use, and fresh frozen plasma transfusion in neonates born from 33 to 36 6/7 gestational weeks. Oligohydramnios and male sex increase the probability for non-normal categories in the three-tiered FHR categorization.
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spelling doaj-art-af03d8a830c549d98b5c3efcca8d0d302025-08-20T03:35:38ZengMDPI AGMedicina1010-660X1648-91442025-06-01617117110.3390/medicina61071171Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate CategorizationJelena Sabljić0Klara Čogelja1Edita Runjić2Blagoja Markoski3Marijana Barbača4Toni Modrić5Boris Bačić6Department of Neonatology, Split University Hospital Centre, 21000 Split, CroatiaDepartment of Neonatology, Split University Hospital Centre, 21000 Split, CroatiaSchool of Medicine, University of Split, 21000 Split, CroatiaDepartment of Obstetrics and Gynecology, Split University Hospital Centre, 21000 Split, CroatiaSchool of Medicine, University of Split, 21000 Split, CroatiaFaculty of Kinesiology, University of Split, 21000 Split, CroatiaSchool of Medicine, University of Split, 21000 Split, Croatia<i>Background and Objectives:</i> Electronic fetal heart rate monitoring is mandatory for preterm labor. Moderate to late preterm neonates have an increased risk of overall morbidity, neonatal intensive care (NICU) admission, and consequently, medication use. The outcome of preterm neonates > 32 weeks of gestation in relation to three-tiered fetal heart rate (FHR) categorization was analyzed. <i>Materials and Methods:</i> This was a single-center, retrospective case-control study conducted from January 2021 to December 2023. The study included 25 FGR and 131 control cases born from 33 to 36 6/7 gestational weeks. Outcome was defined as the need for assistance after birth in first 15 min of life, respiratory outcome, and first day dopamine use and fresh frozen plasma transfusion. Maternal characteristics as risk factors for non-normal categories within three-tiered FHR categorization were also analyzed. <i>Results:</i> There was no significant difference in neonatal outcome among groups, except significantly lower 1 min APGAR and longer LOS in the FGR group. An increasing category within the three-tiered FHR categorization positively correlated with the need for assistance after birth, respiratory outcome, dopamine use, fresh frozen plasma transfusion, and length of hospital stay. Negative correlations were revealed between the increasing category within the three-tiered FHR categorization and first and fifth minute APGAR scores. Oligohydramnios and male sex were risk factors for non-normal categories within three-tiered FHR categorization. The correlation was tested using the Spearman correlation coefficient. A logistic regression model was employed to identify maternal risk factors for the non-normal category within three-tiered FHR categorization. All differences were statistically significant (<i>p</i> < 0.05). <i>Conclusions:</i> The increasing category within three-tiered FHR categorization may alert neonatologists to be highly suspicious of RDS, respiratory support, dopamine use, and fresh frozen plasma transfusion in neonates born from 33 to 36 6/7 gestational weeks. Oligohydramnios and male sex increase the probability for non-normal categories in the three-tiered FHR categorization.https://www.mdpi.com/1648-9144/61/7/1171fetal heart ratecardiotocographyneonatesfetal growth restrictionneonatal respiratory distress syndromefresh frozen plasma
spellingShingle Jelena Sabljić
Klara Čogelja
Edita Runjić
Blagoja Markoski
Marijana Barbača
Toni Modrić
Boris Bačić
Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
Medicina
fetal heart rate
cardiotocography
neonates
fetal growth restriction
neonatal respiratory distress syndrome
fresh frozen plasma
title Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
title_full Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
title_fullStr Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
title_full_unstemmed Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
title_short Outcome of Preterm Neonates > 32 Weeks Gestation in Relation to Three-Tiered Fetal Heart Rate Categorization
title_sort outcome of preterm neonates 32 weeks gestation in relation to three tiered fetal heart rate categorization
topic fetal heart rate
cardiotocography
neonates
fetal growth restriction
neonatal respiratory distress syndrome
fresh frozen plasma
url https://www.mdpi.com/1648-9144/61/7/1171
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