{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:50:03Z","timestamp":1782283803237,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study identifies clinically relevant thresholds for normal and excessive uterine activity (UA) in relation to umbilical artery (UmA) pH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This blinded secondary analysis included 625 term singleton pregnancies from a randomized controlled trial (NCT02941393,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      ) cohort with intrauterine pressure (IUP) monitoring, cephalic presentation, and umbilical cord blood sampling at birth. Measures included IUP expressed as Montevideo units (MVUs), contraction frequency per 10\u2009min, and uterine baseline tone. Associations between UA and UmA pH (\u22647.15) or base excess (linear) were assessed using linear and logistic regression and Student's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With an IUP cutoff &gt;250 MVUs, the proportion of neonates with pH \u22647.15 increased from 16.8% to 25.6% (OR 1.68, 95% CI 1.10\u20132.59;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017). Among oxytocin\u2010stimulated labors (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009579), an IUP cutoff &gt;200 MVUs was associated with an increase in pH \u22647.15 from 14.7% to 21.4% (OR 1.58, 95% CI 1.02\u20132.44;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.038). Elevated baseline tone showed a similar association, with the incidence of pH \u22647.15 increasing from 16.6% to 23.6% at a threshold &gt;20\u2009mmHg (OR 1.59, 95% CI 1.06\u20132.39;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025). A significant downward shift in UmA pH distribution was observed at a contraction frequency &gt;5\/10\u2009min (7.23 [0.09] vs. 7.22 [0.09];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.042), and among oxytocin\u2010stimulated labors, this shift occurred already at &gt;4\/10\u2009min (7.24 [0.08] vs. 7.23 [0.09];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suggested thresholds associated with neonatal acidemia are IUP \u2264250 MVUs, contraction frequency \u22645\/10\u2009min, and baseline tone \u226420\u2009mmHg. For oxytocin\u2010stimulated labors, lower thresholds (IUP \u2264200 MVUs and contraction frequency \u22644\/10\u2009min) appear safer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71151","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:21:47Z","timestamp":1782282107000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterine contractile activity thresholds associated with neonatal acidemia at term: A secondary analysis of a randomized controlled trial cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6324-9928","authenticated-orcid":false,"given":"Milla","family":"Juhantalo","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5124-6735","authenticated-orcid":false,"given":"Tuija","family":"Hautakangas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Hospital Nova, Wellbeing Services County of Central Finland  Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-7486","authenticated-orcid":false,"given":"Outi","family":"Palom\u00e4ki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7282-3653","authenticated-orcid":false,"given":"Jukka","family":"Uotila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.06.018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(88)90100-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb11403.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03219-w"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452666"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.866645"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.691578"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.07.032"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676492"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.11.035"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1998893"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340802220352"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(03)00105-2"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2022-9588"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14838"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.07.001"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006947.pub3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.06.020"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.09.034"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1945577"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16343"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-020-02718-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818f5eb6"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.111720"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.01.026"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:21:48Z","timestamp":1782282108000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":25,"alternative-id":["10.1002\/ijgo.71151"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71151","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijgo.71151"}}