ReviewThe Journal of physiology2018
The peripheral chemoreflex: indefatigable guardian of fetal physiological adaptation to labour.
Review in The Journal of physiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.
- Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum - a systematic review with implications for the function of the oxytocinergic system.BMC pregnancy and childbirth · 2023Pooled it
- Time-surrogate variables enhance the association between cardiotocographic features and intrapartum hypoxic-ischemic encephalopathy.PLOS digital health · 2026Article
- Physiological cardiotocography interpretation and neonatal morbidity: A historical pre-post cohort study in a tertiary perinatal center.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Utility of Admission and Intrapartum Cardiotocography for Predicting Umbilical Artery pH Status at Birth: A Retrospective Cohort Study in Iran.Health science reports · 2026Article
- An interdisciplinary fetal neonatal neurology collaborative promotes integrative life-course brain health.Frontiers in neurology · 2025Review
- Time-Dependent Association Between Cardiotocographic Features and Hypoxic-Ischemic Encephalopathy.IEEE access : practical innovations, open solutions · 2025Article
- Article
- Article
- Interdisciplinary fetal-neonatal neurology training improves brain health across the lifespan.Frontiers in neurology · 2024Review
- Accounting for Nulliparity in the Prediction of Hypoxic-Ischemic Encephalopathy Using Cardiotocography.... IEEE-EMBS International Conference on Biomedical and Health Informatics. IEEE-EMBS International Conference on Biomedical and Health Informatics · 2023Article
- Prediction of Fetal Blood Pressure during Labour with Deep Learning Techniques.Bioengineering (Basel, Switzerland) · 2023Article
- Vitality in Newborn Farm Animals: Adverse Factors, Physiological Responses, Pharmacological Therapies, and Physical Methods to Increase Neonate Vigor.Animals : an open access journal from MDPI · 2023Review
- Foetal Intrapartum Compromise at Term: Could COVID-19 Infection Be Involved? A Case Report.Medicina (Kaunas, Lithuania) · 2023Article
- Predelivery placenta-associated biomarkers and computerized intrapartum fetal heart rate patterns.AJOG global reports · 2023Article
- Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies.BJOG : an international journal of obstetrics and gynaecology · 2022Review
- Is It Time to Redefine Fetal Decelerations in Cardiotocography?Journal of personalized medicine · 2022Review
- The Nonlinear Dynamic Response of Intrapartum Fetal Heart Rate to Uterine Pressure.Computing in cardiology · 2022Article
- Sodium dichloroacetate stimulates cardiac mitochondrial metabolism and improves cardiac conduction in the ovine fetus during labor.American journal of physiology. Regulatory, integrative and comparative physiology · 2022Article
- Machine Learning Algorithm to Predict Acidemia Using Electronic Fetal Monitoring Recording Parameters.Entropy (Basel, Switzerland) · 2021Article
- Analysis of Maternal and Neonatal Complications in a Group of Patients with Gestational Diabetes Mellitus.Medicina (Kaunas, Lithuania) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
The fetus is consistently exposed to repeated periods of impaired oxygen (hypoxaemia) and nutrient supply in labour. This is balanced by the healthy fetus's remarkable anaerobic tolerance and impressive ability to mount protective adaptations to hypoxaemia. The most important mediator of fetal adaptations to brief repeated hypoxaemia is the peripheral chemoreflex, a rapid reflex response to acute falls in arterial oxygen tension. The overwhelming majority of fetuses are able to respond to repeated uterine contractions without developing hypotension or hypoxic-ischaemic injury. In contrast, fetuses who are either exposed to severe hypoxaemia, for example during uterine hyperstimulation, or enter labour with reduced anaerobic reserve (e.g. as shown by severe fetal growth restriction) are at increased risk of developing intermittent hypotension and cerebral hypoperfusion. It is remarkable to note that when fetuses develop hypotension during such repeated severe hypoxaemia, it is not mediated by impaired reflex adaptation, but by failure to maintain combined ventricular output, likely due to a combination of exhaustion of myocardial glycogen and evolving myocardial injury. The chemoreflex is suppressed by relatively long periods of severe hypoxaemia of 1.5-2 min, longer than the typical contraction. Even in this setting, the peripheral chemoreflex is consistently reactivated between contractions. These findings demonstrate that the peripheral chemoreflex is an indefatigable guardian of fetal adaptation to labour.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.