{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:04:43Z","timestamp":1772989483894,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010067","name":"Gobierno de Arag\u00f3n","doi-asserted-by":"publisher","award":["T69_23R"],"award-info":[{"award-number":["T69_23R"]}],"id":[{"id":"10.13039\/501100010067","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify new parameters predicting fetal acidemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case\u2013control study in a cohort of deliveries from a tertiary referral hospital\u2010based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non\u2010NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10\u2009362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC\u2009=\u20090.727). The non\u2010NICHD parameters measured during the 30\u2010min fetal monitoring, total deceleration area (AUC\u2009=\u20090.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC\u2009=\u20090.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC\u2009=\u20090.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.15454","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T05:53:50Z","timestamp":1709618030000},"page":"859-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The utility of fetal heart rate deceleration's descending slope in searching for a non\u2010National Institute of Child Health and Human Development parameter for the detection of fetal acidosis"],"prefix":"10.1002","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9850-6074","authenticated-orcid":false,"given":"Berta","family":"Cast\u00e1n\u00a0Larraz","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Miguel Servet  Zaragoza Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-302X","authenticated-orcid":false,"given":"Luis Mariano","family":"Esteban","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics, Escuela Universitaria Polit\u00e9cnica de La Almunia, Institute for Biocomputation and Physics of Complex Systems (BIFI) Universidad de Zaragoza  Zaragoza 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