Related Experiment Video
Updated: May 30, 2026
A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
Correlation between fetal heart rate reactivity and mortality and severe neurological morbidity in extremely low
S Eventov-Friedman1, E S Shinwell, E Barnea
1Department of Neonatology, Kaplan Medical Center, Rehovot and Hebrew University, Jerusalem, Israel.
Insights
Fetal heart rate (FHR) reactivity absence is linked to higher death and severe intraventricular hemorrhage (IVH) rates in extremely low birth weight (ELBW) infants. This finding aids in predicting short-term outcomes for high-risk newborns.
Area of Science:
- Neonatalogy
- Perinatology
- Fetal Medicine
Background:
- Extremely low birth weight (ELBW) infants face significant short-term morbidities.
- Fetal heart rate (FHR) monitoring is crucial for assessing fetal well-being before delivery.
- Identifying predictors of adverse outcomes in ELBW infants is essential for timely intervention.
Purpose of the Study:
- To investigate the association between specific fetal heart rate (FHR) abnormalities and adverse outcomes in ELBW infants.
- To determine if FHR patterns predict death, severe intraventricular hemorrhage (IVH), or periventricular echogenicity (PVE) within 4 days of birth.
Main Methods:
- Retrospective analysis of live-born ELBW infants (≤ 30 weeks' gestation) born between 2000-2007.
- FHR monitoring data from the 24 hours preceding delivery were analyzed for baseline rate, reactivity, variability, and decelerations.
- Cranial ultrasound was performed within the first 4 days of life to assess for IVH and PVE.
Main Results:
- Absence of FHR reactivity was significantly associated with increased risk of death (OR 3.45) and severe IVH (OR 3.33) within 4 days.
- No significant association was found between FHR parameters and periventricular echogenicity (PVE).
- Other analyzed FHR patterns did not correlate with adverse neonatal outcomes.
Conclusions:
- Fetal heart rate reactivity is a potential predictor of short-term adverse outcomes in ELBW infants.
- This finding can assist in parental counseling regarding the prognosis of extremely preterm births.
- FHR monitoring may offer valuable insights into the immediate neonatal risk profile.
Objective:
To determine the correlation between specific fetal heart rate (FHR) abnormalities and the incidence of death, severe (grade 3-4) intraventricular hemorrhage (IVH) and periventricular echogenicity (PVE) in extremely low birth weight infants (ELBW) within the first 4 days after birth.
Methods:
The study included live-born ELBW infants ≤ 30 weeks' gestation who were born in 2000-2007 at Kaplan Medical Center, Rehovot, Israel, and, who had FHR monitoring during the 24 h before delivery and cranial ultrasound during the first 4 days of life. FHR pattern was analyzed for the presence of baseline rate, reactivity, variability and decelerations.
Results:
96 infants with mean birth weight 757 ± 150 g and mean gestational age 25.8 ± 1.5 weeks were included. By 4 days of life, 23/96 (24%) died, 17/96 (18%) developed severe IVH and 31/96 (32%) had PVE. Absence of reactivity was significantly associated with increase in both death (p = 0.02, OR 3.45, 95% CI: 1.22-9.47 and severe IVH (p = 0.029, OR 3.33, 95% CI: 1.25-10) but not with PVE. Other FHR parameters were not associated with adverse outcome.
Conclusion:
These results suggest that FHR reactivity may be of value in predicting short-term outcome in ELBW infants. This may be helpful in counseling parents with imminent extremely preterm birth.
