AUTHOR=Medeiros Thâmila Kamila de Souza , Dobre Mirela , da Silva Daniela Monteiro Baptista , Brateanu Andrei , Baltatu Ovidiu Constantin , Campos Luciana Aparecida 

TITLE=Intrapartum Fetal Heart Rate: A Possible Predictor of Neonatal Acidemia and APGAR Score

JOURNAL=Frontiers in Physiology

VOLUME=Volume 9 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.01489

DOI=10.3389/fphys.2018.01489

ISSN=1664-042X

ABSTRACT=Background: Predicting perinatal outcomes based on patterns of fetal heart rate (FHR) remains a challenge.  The aim of this study was to evaluate intrapartum FHR variability as possible predictor for neonatal acidemia and APGAR score.
Methods: This was a cross-sectional study of 552 childbirths. Multivariable linear regression models were used to assess the association between FHR variability and each of the following outcomes: arterial cord blood pH and base deficit, Apgar 1 and 5 scores. Variables used for adjustment were mother age, comorbidities (gestational diabetes, preeclampsia, maternal fever, hypertension), parity, gravidity, uterine contractions, and newborn gestational age and weight at birth.
Results: The following factors were associated with an increased risk of metabolic acidosis and low Apgar scores at birth: increased mean and coefficient of variation of the FHR, type of delivery and decreased parity. 
Each 10-beat/min increase in the FHR was associated with an increase of 0.43 mEq/L in the base deficit, and a decrease of 0.01 in the pH, 0.2 in the Apgar 1 and 0.14 in the Apgar 5 scores. Each 10% increase in the coefficient of variation of the FHR was associated with an increase of 4.05 mEq/L in the base deficit and a decrease of 0.13 in the pH, 1.31 in the Apgar 1 and 0.86 in the Apgar 5 scores.
Conclusions: These data suggest the intrapartum FHR variability is physiologically relevant and can be used for predicting the acidemia and Apgar scores at birth.