{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:55Z","timestamp":1790927635820,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Intrapartum cardiotocography (CTG) is used to detect fetal hypoxia, but static classifications can miss progressive compromise. This study analyzes longitudinal CTG trends to find early predictors of umbilical artery acidemia (pH\u2009&lt;\u20097.20) at birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study analyzed vaginal deliveries (2019\u20132022) at a tertiary hospital. Singleton pregnancies were stratified into cases (pH\u2009&lt;\u20097.2,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200970) and controls (pH\u2009\u2265\u20097.2,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009182). CTG tracings were assessed for baseline FHR, beat\u2010to\u2010beat variability (BTBV), accelerations, and decelerations at four timepoints: admission, latent and active first\u2010stage labor, and second\u2010stage labor. Univariate and multivariate logistic regression (adjusted for maternal age, comorbidities, and gestational age) identified predictors, with receiving operating characteristic (ROC) analysis evaluating predictive performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that neonatal acidemia at birth was predicted by elevated baseline FHR at admission, contrasted with decreased FHR during active first\u2010stage and second\u2010stage labor. Progressive reduction in BTBV showed a strong association at all stages of labor, most prominent at second\u2010stage labor, absent accelerations during first\u2010stage labor, and presence of decelerations, especially late decelerations during second\u2010stage labor. ROC analysis demonstrated excellent predictive performance for second\u2010stage BTBV (AUC\u2009=\u20090.992) and baseline FHR (AUC\u2009=\u20090.914).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Specific evolving CTG patterns effectively predicted fetal acidemia. Parameters from the second stage of labor were most predictive, underscoring the critical importance of continuous monitoring to identify high\u2010risk cases and guide timely intervention for fetal hypoxia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73009","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T03:50:32Z","timestamp":1786333832000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Admission and Intrapartum Cardiotocography for Predicting Umbilical Artery pH Status at Birth: A Retrospective Cohort Study in Iran"],"prefix":"10.1002","volume":"9","author":[{"given":"Fatemeh","family":"Golshahi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrokh","family":"Sahebdel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8187-5738","authenticated-orcid":false,"given":"Nafiseh","family":"Saedi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboobeh","family":"Shirazi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jafar","family":"Golshahi","sequence":"additional","affiliation":[{"name":"Isfahan Cardiovascular Research Center Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9649-3424","authenticated-orcid":false,"given":"Azita","family":"Zare","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooshin","family":"Faraji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yas Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-0603","authenticated-orcid":false,"given":"Zahra","family":"Hamidi Madani","sequence":"additional","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine Guilan University 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