Purpose: The aim of the study was to estimate by a survival analysis model the hazard function (HF) for neonatal metabolic acidemia (MA) throughout the 2nd stage of labor (2STG) at the time of occurrence of a terminal bradycardia ≥ 10 min requiring expedited delivery, and the cumulative incidence function (CIF) for MA according with the duration of bradycardia stratified in 10-12 min and > 12 min. Methods: Singleton pregnancies experiencing terminal fetal bradycardia requiring expedited delivery in the 2STG at 38 + 0-41 + 3 weeks and delivering in the year 2019, were identified. The presence of MA (pH < 7 and/or BE ≤ - 12 mmol/L) was determined based on the acid-base status in the umbilical artery cord blood. Survival analysis was used to assess the hazard function (HF) and the cumulative incidence function (CIF) for MA occurring after terminal fetal bradycardia, at the 2STG. Results: Out of a non-consecutive population of 12,331 pregnancies, there were 52 cases that fit the inclusion criteria. Twenty-four (46.2%) of those develop MA. Abnormal quantitative pH values and the HF for MA correlated with the duration of 2STG at the time of bradycardia onset, but not with bradycardia duration. After 60 min of duration of 2STG, the HF (or instantaneous rate of failure) increased dramatically (from 1.2 to 20 about at 120 min). At paired duration of 2STG, a higher CIF was observed for the terminal bradycardia > 12 min. Conclusion: Forty-six percent of term fetuses with terminal bradycardia had MA at birth. Despite the low sensitivity and a non-significant association with quantitative pH values, the duration of terminal bradycardia in the 2STG is associated with a higher CIF for MA.

The cumulative incidence of neonatal metabolic acidemia after terminal bradycardia in the 2nd stage of labor: a survival-based model / Seidenari, Anna; Cavoretto, Paolo Ivo; Carbone, Ilma Floriana; Germano, Chiara; Iurlaro, Enrico; Gaeta, Gerarda; Cetera, Giulia Emily; Amodeo, Silvia; Morano, Danila; Masturzo, Bianca; Di Martino, Daniela Denis; Giambanco, Laura; Candiani, Massimo; Farina, Antonio. - In: ARCHIVES OF GYNECOLOGY AND OBSTETRICS. - ISSN 1432-0711. - ELETTRONICO. - Online ahead of print:(2022), pp. Online ahead of print-Online ahead of print. [10.1007/s00404-022-06619-9]

The cumulative incidence of neonatal metabolic acidemia after terminal bradycardia in the 2nd stage of labor: a survival-based model

Seidenari, Anna;Morano, Danila;Farina, Antonio
2022

Abstract

Purpose: The aim of the study was to estimate by a survival analysis model the hazard function (HF) for neonatal metabolic acidemia (MA) throughout the 2nd stage of labor (2STG) at the time of occurrence of a terminal bradycardia ≥ 10 min requiring expedited delivery, and the cumulative incidence function (CIF) for MA according with the duration of bradycardia stratified in 10-12 min and > 12 min. Methods: Singleton pregnancies experiencing terminal fetal bradycardia requiring expedited delivery in the 2STG at 38 + 0-41 + 3 weeks and delivering in the year 2019, were identified. The presence of MA (pH < 7 and/or BE ≤ - 12 mmol/L) was determined based on the acid-base status in the umbilical artery cord blood. Survival analysis was used to assess the hazard function (HF) and the cumulative incidence function (CIF) for MA occurring after terminal fetal bradycardia, at the 2STG. Results: Out of a non-consecutive population of 12,331 pregnancies, there were 52 cases that fit the inclusion criteria. Twenty-four (46.2%) of those develop MA. Abnormal quantitative pH values and the HF for MA correlated with the duration of 2STG at the time of bradycardia onset, but not with bradycardia duration. After 60 min of duration of 2STG, the HF (or instantaneous rate of failure) increased dramatically (from 1.2 to 20 about at 120 min). At paired duration of 2STG, a higher CIF was observed for the terminal bradycardia > 12 min. Conclusion: Forty-six percent of term fetuses with terminal bradycardia had MA at birth. Despite the low sensitivity and a non-significant association with quantitative pH values, the duration of terminal bradycardia in the 2STG is associated with a higher CIF for MA.
2022
The cumulative incidence of neonatal metabolic acidemia after terminal bradycardia in the 2nd stage of labor: a survival-based model / Seidenari, Anna; Cavoretto, Paolo Ivo; Carbone, Ilma Floriana; Germano, Chiara; Iurlaro, Enrico; Gaeta, Gerarda; Cetera, Giulia Emily; Amodeo, Silvia; Morano, Danila; Masturzo, Bianca; Di Martino, Daniela Denis; Giambanco, Laura; Candiani, Massimo; Farina, Antonio. - In: ARCHIVES OF GYNECOLOGY AND OBSTETRICS. - ISSN 1432-0711. - ELETTRONICO. - Online ahead of print:(2022), pp. Online ahead of print-Online ahead of print. [10.1007/s00404-022-06619-9]
Seidenari, Anna; Cavoretto, Paolo Ivo; Carbone, Ilma Floriana; Germano, Chiara; Iurlaro, Enrico; Gaeta, Gerarda; Cetera, Giulia Emily; Amodeo, Silvia; Morano, Danila; Masturzo, Bianca; Di Martino, Daniela Denis; Giambanco, Laura; Candiani, Massimo; Farina, Antonio
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/912990
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact