Relevant obstetric factors associated with fetal heart rate monitoring for cerebral palsy in pregnant women with hypertensive disorder of pregnancy

• Published in: The journal of obstetrics and gynaecology research Vol. 44; no. 4; pp. 647 - 654
• Main Authors: Hasegawa, Junichi, Ikeda, Tomoaki, Toyokawa, Satoshi, Jojima, Emi, Satoh, Shoji, Ichizuka, Kiyotake, Tamiya, Nanako, Nakai, Akihito, Fujimori, Keiya, Maeda, Tsugio, Masuzaki, Hideaki, Takeda, Satoru, Suzuki, Hideaki, Ueda, Shigeru, Ikenoue, Tsuyomu
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.04.2018; Wiley Subscription Services, Inc
• Subjects: Abruptio Placentae - epidemiology; Adult; Birth weight; Bradycardia; Bradycardia - diagnosis; Bradycardia - epidemiology; Cerebral palsy; Cerebral Palsy - diagnosis; Cerebral Palsy - epidemiology; Female; fetal heart rate; Fetuses; Gestational age; Heart rate; Heart Rate, Fetal - physiology; Humans; Hypertension; Hypertension, Pregnancy-Induced - epidemiology; hypertensive disorder of pregnancy; Hypoxia; Infant, Low Birth Weight - physiology; Infant, Newborn; Male; Neonates; Obstetrics; Original; Paralysis; Placenta; placental abruption; Pregnancy; Prenatal Diagnosis; cerebral palsy; hypoxia; placental abruption; hypertension; hypertensive disorder of pregnancy; fetal heart rate
• ISSN: 1341-8076; 1447-0756; 1447-0756
• DOI: 10.1111/jog.13555

Aim The study identifies the relevant obstetric factors associated with fetal heart rate (FHR) monitoring for cerebral palsy (CP) in pregnant women with hypertensive disorders of pregnancy (HDP). Methods The subjects were neonates with CP (birth weight ≥ 2000 g, gestational age ≥ 33 weeks) who were approved for compensation for CP by the Operating Organization of the Japan Obstetric Compensation System between 2009 and 2012. After selection of women with antepartum HDP, obstetric characteristics associated with FHR monitoring were analyzed. Results The subjects included 33 neonates with CP whose mothers suffered from HDP during pregnancy and 450 neonates whose mothers did not develop HDP. The rates of placental abruption (48.5% vs. 20%; P < 0.001) and light‐for‐gestational age (12.1% vs. 2.2%; P = 0.011) were significantly higher in women with HDP than in those without HDP. Regarding FHR pattern analysis, fetal bradycardia was observed on admission to hospital in 94% of women with placental abruption. In women without placental abruption, FHR was likely to indicate a favorable pattern on admission, but became worse with the progression of labor. Conclusion This is first study to clinically demonstrate FHR patterns in CP cases in association with HDP. Although antepartum CP is undetectable, pregnant women with HDP should be placed under strict observation and management to minimize fetal hypoxic conditions during labor.