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Am J Perinatol 2005; 22(4): 181-187
DOI: 10.1055/s-2005-867090
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Association of Nonreassuring Fetal Heart Rate Patterns and Subsequent Cerebral Palsy in Pregnancies with Intrauterine Bacterial Infection

Hiroshi Sameshima1 , Tsuyomu Ikenoue1 , Tomoaki Ikeda1 , Masato Kamitomo1 , Satoshi Ibara1
  • 1Department of Obstetrics and Gynecology and Perinatal Center, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan
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Publication History

Publication Date:
02 May 2005 (online)

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ABSTRACT

We evaluated an association of nonreassuring fetal heart rate (FHR) patterns and subsequent cerebral palsy (CP) in pregnancies with intrauterine bacterial infection. Among 10,030 infants born during 1995 to 2000, 139 were complicated with acute intrauterine bacterial infection in labor. The FHR patterns 2 hours immediately before delivery were interpreted according to the guidelines of the National Institute of Child Health and Human Development. The correlations between the FHR patterns and umbilical blood gases, as well as FHR patterns and CP were studied. Statistics included unpaired t test, contingency table with χ2 and Fisher test, and one-way analysis of variance with Bonferroni/Dunn test. Fifteen infants (11%) developed CP at 2 years or older. Nonreassuring FHR patterns including recurrent late deceleration, severe variable deceleration, and prolonged deceleration occurred in 24% of pregnancies with intrauterine infection. Incidence of CP was not different according to the FHR deceleration patterns or umbilical pH values. Multiple logistic regression analysis revealed that fetal tachycardia (OR, 11; 95% CI, 1.8 to 67) and lower gestational age (< 34 weeks; OR, 9.4; 95% CI, 0.96 to 93) was associated with CP in intrauterine infection. Nonreassuring FHR patterns were increased in intrauterine infection. CP occurred more frequently and was associated with tachycardia and lower gestational age, but not with FHR deceleration patterns or acidemia, suggesting different pathophysiology from acute hypoxia-ischemia.

KEYWORDS

Acidemia - cerebral palsy - fetal heart rate monitoring - intrauterine infection - tachycardia

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Hiroshi SameshimaM.D. 

Department of Obstetrics and Gynecology, Miyazaki Medical College

5200 Kihara, Kiyotake, Miyazaki 892-1601, Japan

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