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Journal of Pregnancy
Volume 2018, Article ID 2195965, 8 pages
https://doi.org/10.1155/2018/2195965
Research Article

Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study

Department of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UK

Correspondence should be addressed to Habiba Kapaya; ku.ca.dleiffehs@ayapak.h

Received 4 June 2018; Revised 19 July 2018; Accepted 30 July 2018; Published 2 September 2018

Academic Editor: Luca Marozio

Copyright © 2018 Habiba Kapaya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purpose of this study was to evaluate whether obstetric risk factors are associated with fetal acidaemia at delivery. Methodology. In a case-control study, 294 women with term singleton pregnancies complicated by an umbilical artery cord pH < 7.20 at birth were individually matched by controls with umbilical artery cord pH > 7.20. Groups were compared for differences in maternal, obstetric, and fetal characteristics using logistic regression models presented as odds ratio (OR) with 95% confidence intervals (CI). Results. The study showed pregestational diabetes (PGDM) [OR: 5.31, 95% CI: 1.15- 24.58, P = 0.018], urinary tract infection (UTI) [OR: 3.21, 95% CI: 1.61- 6.43, P < 0.001], and low Apgar scores to be significantly associated with acidaemia, whereas low maternal BMI [OR: 0.19, 95% CI: 0.04-0.87, P = 0.032], pyrexia in labour [OR 0.23; 95% CI 0.12-0.53; P < 0.001], electronic fetal monitoring (EFM) [OR 0.65; 95% CI 0.43-0.99; P = 0.042), and emergency caesarean section [OR 0.42; 95% CI 0.26-0.66; P < 0.001] were found to be protective of acidaemia. Conclusion. Certain obstetric risk factors before and during labour can identify newborns at risk of developing acidaemia. Further research is needed to gain quantitative insight into the predictive capacity of these risks that can inform obstetric clinical management for improved outcomes.