Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study

Background. Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purp...

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Main Authors: Habiba Kapaya, Roslyn Williams, Grace Elton, Dilly Anumba
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Pregnancy
Online Access:http://dx.doi.org/10.1155/2018/2195965
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author Habiba Kapaya
Roslyn Williams
Grace Elton
Dilly Anumba
author_facet Habiba Kapaya
Roslyn Williams
Grace Elton
Dilly Anumba
author_sort Habiba Kapaya
collection DOAJ
description Background. Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purpose of this study was to evaluate whether obstetric risk factors are associated with fetal acidaemia at delivery. Methodology. In a case-control study, 294 women with term singleton pregnancies complicated by an umbilical artery cord pH < 7.20 at birth were individually matched by controls with umbilical artery cord pH > 7.20. Groups were compared for differences in maternal, obstetric, and fetal characteristics using logistic regression models presented as odds ratio (OR) with 95% confidence intervals (CI). Results. The study showed pregestational diabetes (PGDM) [OR: 5.31, 95% CI: 1.15- 24.58, P = 0.018], urinary tract infection (UTI) [OR: 3.21, 95% CI: 1.61- 6.43, P < 0.001], and low Apgar scores to be significantly associated with acidaemia, whereas low maternal BMI [OR: 0.19, 95% CI: 0.04-0.87, P = 0.032], pyrexia in labour [OR 0.23; 95% CI 0.12-0.53; P < 0.001], electronic fetal monitoring (EFM) [OR 0.65; 95% CI 0.43-0.99; P = 0.042), and emergency caesarean section [OR 0.42; 95% CI 0.26-0.66; P < 0.001] were found to be protective of acidaemia. Conclusion. Certain obstetric risk factors before and during labour can identify newborns at risk of developing acidaemia. Further research is needed to gain quantitative insight into the predictive capacity of these risks that can inform obstetric clinical management for improved outcomes.
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spelling doaj-art-f897d42e6bc8478cb0f79957c4cf407d2025-08-20T03:20:09ZengWileyJournal of Pregnancy2090-27272090-27352018-01-01201810.1155/2018/21959652195965Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control StudyHabiba Kapaya0Roslyn Williams1Grace Elton2Dilly Anumba3Department of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UKDepartment of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UKDepartment of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UKDepartment of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UKBackground. Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purpose of this study was to evaluate whether obstetric risk factors are associated with fetal acidaemia at delivery. Methodology. In a case-control study, 294 women with term singleton pregnancies complicated by an umbilical artery cord pH < 7.20 at birth were individually matched by controls with umbilical artery cord pH > 7.20. Groups were compared for differences in maternal, obstetric, and fetal characteristics using logistic regression models presented as odds ratio (OR) with 95% confidence intervals (CI). Results. The study showed pregestational diabetes (PGDM) [OR: 5.31, 95% CI: 1.15- 24.58, P = 0.018], urinary tract infection (UTI) [OR: 3.21, 95% CI: 1.61- 6.43, P < 0.001], and low Apgar scores to be significantly associated with acidaemia, whereas low maternal BMI [OR: 0.19, 95% CI: 0.04-0.87, P = 0.032], pyrexia in labour [OR 0.23; 95% CI 0.12-0.53; P < 0.001], electronic fetal monitoring (EFM) [OR 0.65; 95% CI 0.43-0.99; P = 0.042), and emergency caesarean section [OR 0.42; 95% CI 0.26-0.66; P < 0.001] were found to be protective of acidaemia. Conclusion. Certain obstetric risk factors before and during labour can identify newborns at risk of developing acidaemia. Further research is needed to gain quantitative insight into the predictive capacity of these risks that can inform obstetric clinical management for improved outcomes.http://dx.doi.org/10.1155/2018/2195965
spellingShingle Habiba Kapaya
Roslyn Williams
Grace Elton
Dilly Anumba
Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
Journal of Pregnancy
title Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
title_full Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
title_fullStr Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
title_full_unstemmed Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
title_short Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
title_sort can obstetric risk factors predict fetal acidaemia at birth a retrospective case control study
url http://dx.doi.org/10.1155/2018/2195965
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AT graceelton canobstetricriskfactorspredictfetalacidaemiaatbirtharetrospectivecasecontrolstudy
AT dillyanumba canobstetricriskfactorspredictfetalacidaemiaatbirtharetrospectivecasecontrolstudy