Evidence map›Paper›PMID 37156754›Full record

Observational studyBJOG : an international journal of obstetrics and gynaecology2023

Risk factors for a serious adverse outcome in neonates: a retrospective cohort study of vaginal births.

Sita Jindal, Philip J Steer, Makrina Savvidou, Tim Draycott, Mary Dixon-Woods, Angela Wood, Lois G Kim

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BJOG : an international journal of obstetrics and gynaecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
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  5. Risk factors for a serious adverse outcome in neonates: a retrospective cohort study of vaginal births.BJOG : an international journal of obstetrics and gynaecology · 2023
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Sita JindalAcademic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK.
Philip J SteerAcademic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK.
Makrina SavvidouAcademic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK.
Tim DraycottThe Royal College of Obstetricians and Gynaecologists, London, UK.
Mary Dixon-WoodsDepartment of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK.
Angela WoodDepartment of Public Health and Primary Care / Cardiovascular Epidemiology Unit, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
Lois G KimDepartment of Public Health and Primary Care / Cardiovascular Epidemiology Unit, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
Chelsea and Westminster Hospital · GBUniversity of Cambridge · GBRoyal College of Obstetricians and Gynaecologists · GB

Funding

British Heart Foundation CH/12/2/29428British Heart Foundation RG/13/13/30194; RG/18/13/33946
6 · The paper itself

Abstract

objectiveTo investigate the hypothesis that risk factors in addition to an abnormal fetal heart rate pattern (aFHRp) are independently associated with adverse neonatal outcomes of labour.

designObservational prospective cohort study.

setting17 UK maternity units. SAMPLE: 585 291 pregnancies between 1988 and 2000 inclusive.

methodsAdjusted odds ratios (OR) with 95% confidence intervals (95% CI) were estimated from multivariable logistic regression.

main outcome measuresAdverse neonatal outcome at term (5-minute Apgar score <7, and a composite measure comprising 5-minute Apgar score <7, resuscitation by intubation and/or perinatal death).

resultsAnalysis was based on 302 137 vaginal births at 37-42 weeks inclusive. We found a higher odds of Apgar score at 5 minutes <7 with suspected fetal growth restriction (OR 1.34, 95% CI 1.16-1.53), induction of labour (OR 1.41, 95% CI 1.25-1.58), nulliparity (OR 1.48, 95% CI 1.34-1.63), booking body mass index ≥30 (OR 1.18, 95% CI 1.02-1.37), maternal age <25 (OR 1.23, 95% CI 1.10-1.39), black ethnicity (OR 1.21, 95% CI 1.03-1.43), early-term birth at 37-38 weeks (OR 1.13, 95% CI 1.02-1.25), late-term birth at 41-42 weeks (OR 1.14, 95% CI 1.01-1.28), use of oxytocin (OR 1.27, 95% CI 1.14-1.41), maternal pyrexia (OR 1.87, 95% CI 1.46-2.40), aFHRp and presence of meconium (aFHRp without meconium: OR 2.40, 95% CI 2.15-2.69; meconium without aFHRp: OR 2.20, 195% CI.94-2.49; both aFHRp and meconium: OR 4.26, 95% CI 3.74-4.87). The results were similar when the composite adverse outcome was considered.

conclusionsA range of risk factors, including suspicion of fetal growth restriction, maternal pyrexia and presence of meconium, are implicated in poor birth outcomes in addition to aFHRp. Interpretation of the fetal heart rate pattern alone is insufficient as a basis for decisions about escalation and intervention.

Indexed as

Cesarean SectionFetal Growth RetardationFemaleFeverHumansInfant, NewbornPregnancyProspective StudiesRetrospective StudiesRisk Factorsfetal deteriorationintrapartum fetal monitoringlabour outcomemeconiumpyrexiarisk factors

Identifiers

PMID37156754
PMCPMC10952606
OpenAlexW4375850883

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.