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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 2

(529) Is there a role for maternal oxygen for fetal resuscitation in high risk gestations?

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Level 1 evidence indicates that maternal oxygen (O2) administration is ineffective for fetal resuscitation in low-risk patient populations. We investigated whether intrapartum maternal O2 administration benefits patients at high risk of placental insufficiency in labor.

Study Design: This is a secondary analysis of two randomized controlled trials at a single center comparing O2 at 10L/min to room air (RA) in term patients with Category II fetal heart tracings in active labor. For this analysis, patients were categorized into high- and low- risk cohorts, with high-risk defined as those with fetal growth restriction, chronic hypertension, hypertensive disorders of pregnancy, tobacco use, and/or gestational diabetes requiring medications. The primary outcome was umbilical artery (UA) pH < 7.20. Multivariable logistic regression was used to account for potential confounders. Interaction testing was performed to assess effect modification.

Results: 320 patients were recruited across both trials, among which 265 had validated UA pH values and were included. There were no statistically significant demographic or delivery differences between those receiving O2 versus RA in the total cohort or among high-risk gestations (Table 1). There was no difference in rate of pH < 7.2 between O2 and RA groups in the entire cohort (28.9% vs 23.9%, aOR 1.27 (95% confidence interval 0.73, 2.21). In a stratified analysis assessing pH < 7.2 in high- and low-risk groups, O2 was not associated with a significant reduction in pH < 7.2 in either group, with no evidence of effect modification (p for interaction=0.97)

Conclusion: This secondary analysis suggests that there is no differential benefit for intrapartum maternal O2 supplementation among high risk gestations. This supports ACOG’s recommendation to deimplement this practice.