Poster Session 1
Natalie L. Neff, MD
Maternal Fetal Medicine Fellow
McGovern Medical School at UT Health
Houston, Texas, United States
Kristen A. Cagino, MD
Maternal Fetal Medicine Fellow
UT Houston
Houston, Texas, United States
Aaron W. Roberts, MD
Assistant Professor
McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Rachel L. Wiley, MD, MPH (she/her/hers)
MFM Fellow
University of California, San Diego
San Diego, California, United States
Shareen Patel, MD
Resident
McGovern Medical School at UTHealth
Houston, Texas, United States
Christina Cortes, MD (she/her/hers)
Resident
McGovern Medical School at UTHealth
Houston, Texas, United States
Kimen S. Balhotra, MD (she/her/hers)
Maternal Fetal Medicine Fellow
McGovern Medical School at UTHealth
Houston, TX, United States
Khalil M. Chahine, MD
Resident
McGovern Medical School at UTHealth
Houston, Texas, United States
Tala Ghorayeb, MD
McGovern Medical School at UTHealth
Houston, Texas, United States
Holly Flores, DO
Resident
University of Texas Health Science Center
Houston, Texas, United States
Fabrizio Zullo, MD (he/him/his)
Ob/Gyn Resident
University of Rome La Sapienza
Rome, Lazio, Italy
Suneet P. Chauhan, MD
Director of MFM Research
Delaware Center of Maternal-Fetal Medicine at Christiana Care
Delaware, Delaware, United States
Hector M. Mendez-Figueroa, MD
Associate Professor
McGovern Medical School at UTHealth
Houston, Texas, United States
The purpose of this study was to compare the characteristics of fetal heart rate tracing (FHRT), and outcomes among small- (birthweight [BW] < 10% for gestational age [GA]; SGA) versus appropriate- (BW at 10-89% for GA; AGA) who labored at term (> 37 weeks).
Study Design:
This is a large retrospective cohort study performed within a 15-month period at a Level IV center. FHRTs of all consecutive deliveries were reviewed by physicians blinded to maternal and neonatal outcomes. The inclusion criteria for the analysis were non-anomalous singletons, who labored at term, and were SGA or AGA using Alexander et al nomogram. In 20 minute segments, the last 60 minutes of tracing were characterized. Rates of cesarean delivery and composite neonatal adverse outcomes (CNAO) were compared. Chi-square test was used to compare groups, with p-value < 0.05 considered significant.
Results:
Of 5,160 consecutive deliveries, 3,029 (58.7%) met the inclusion criteria and among them, 422 (13.9%) were SGA and 2,607 (86.1%) AGA. Baseline characteristics were similar between groups, however SGA compared to AGA were more likely to be nulliparous (52.6% vs. 41.5%, p< 0.01), self-describe as Non-Hispanic Black race (49.8% vs 35.9%, p< 0.01), and have a BMI < 30 kg/m2 (48.3% vs 35.2%, p< 0.01). There were no differences in FHRT baseline, variability or accelerations. Compared to AGA, SGA was more likely to have prolonged decelerations (1.2% vs. 2.9%, p=0.04), variable plus late decelerations (53.1% vs. 47.8%, p=0.04), recurrent decelerations (38.6% vs. 30.9%, p< 0.01), and category II FHRT (76.1% vs. 68.3%, p< 0.01). AGA was more likely to exhibit category I FHRT (p< 0.01). Cesarean delivery for non-reassuring FHRT occurred similarly in the two groups (p=0.18). CNAO occurred in 0.7% of SGA and 0.8% of AGA neonates (p=0.90). CMAO occurred in 6.4% of SGA and 7.6% of AGA neonates (p=0.37).
Conclusion:
In our cohort, category II fetal heart rate tracing was significantly more common in small for gestational age neonates, however we were not able to link these abnormalities with adverse outcomes.
