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Change in heart rate variability in relation to a significant ST-event associates with newborn metabolic acidosis

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Abstract:

Objective

To find whether low-to-high frequency (LF/HF) ratio of fetal heart rate (FHR) variability changes in relation to a significant ST-event during delivery, and if the change is predictive of metabolic acidosis of the newborn. Design

A case–control study. Setting

Data from a multicentre project. Subjects

Acidotic and control fetuses with abnormal cardiotocography together with a ST-event in fetal electrocardiogram (ECG). Methods

We studied intrapartum FHR variability with spectral analysis from 34 fetuses with a significant ST-event in the fetal ECG. LF/HF ratio of FHR variability was measured within a period of 1 hour before and 1 hour after a significant ST-event. Sensitivity and specificity of the change in LF/HF ratio of FHR variability in prediction of metabolic acidosis (pH ≤ 7.05 and base deficit value > 12.0 mmol/l) of the newborn were described by means of the receiver operating characteristic curve. Main outcome measures

Change in LF/HF ratio of FHR in relation to a significant ST-event. Results

We found that a relative change in LF/HF ratio greater than 30% in relation to a significant ST-event predicted cord arterial metabolic acidosis with a sensitivity of 89% (95% CI 68–100%) and specificity of 80% (95% CI 64–96%). Conclusions

Relative changes in LF/HF ratio of FHR variability in relation to a significant ST-event are more pronounced in fetuses born with metabolic acidosis.

Keywords: Fetal electrocardiography; ST-event; fetal heart rate variability; labour; metabolic acidosis; power spectra

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2007.01369.x

Affiliations: 1: Department of Pediatrics, Hospital for Children and Adolescents, Helsinki, Finland 2: Department of Obstetrics and Gynecology and 3: Department of Biostatistics, University of Turku, Turku, Finland 4: Perinatal Centre, Department of Physiology, University of Gothenburg, Gothenburg, Sweden

Publication date: July 1, 2007

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