Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 6; pp. 491.e1 - 491.e10
• Main Authors: Chen, Han-Yang, MS, Chauhan, Suneet P., MD, Ananth, Cande V., PhD, MPH, Vintzileos, Anthony M., MD, Abuhamad, Alfred Z., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2011; Elsevier
• Subjects: Apgar score; Biological and medical sciences; Cardiotocography; electronic fetal heart rate monitoring; Gynecology. Andrology. Obstetrics; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases - epidemiology; Medical sciences; neonatal mortality; neonatal seizure; Obstetrics and Gynecology; Perinatal Mortality; Risk Factors; United States - epidemiology; United States; North America; America; Apgar score; electronic fetal heart rate monitoring; neonatal seizure; infant mortality; neonatal mortality; Human; Neonatal; Cardiotocography; Newborn; Prognosis; Gynecology; Mortality; Electronics; Infant; Epidemiology; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.04.024

Objective To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity. Study Design We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders. Results In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores <4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65). Conclusion In the United States, the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality.