{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:29:05Z","timestamp":1779100145803,"version":"3.51.4"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n            Objective\u2003Current practice guidelines for laboring patients with category II intrapartum tracings recommend maternal oxygen supplementation despite emerging randomized data challenging its benefit and utility. We aim to validate that de-implementing maternal oxygen supplementation for fetal resuscitation did not increase the risk of neonatal acidemia in a real-world setting.<\/jats:p><jats:p>\n            Study Design\u2003This is a retrospective observational study conducted at a single tertiary care center from January 2019 to June 2021. All laboring deliveries during the study period were reviewed and eligible participants included singleton or twin pregnancies between 23 and 42 weeks gestational age with persistent category II tracings. Known major fetal anomalies, contraindications to labor, and maternal indication for O2 supplementation, including active coronavirus disease 2019, were excluded. Cohorts were allocated based on the time of delivery. Those occurring prior to our hospital policy change were identified as historical controls and deliveries after April 1, 2020, as the postdeimplementation cohort. The primary outcome was fetal acidemia, defined as umbilical cord pH\u2009&lt;\u20097.2. Secondary outcomes included severe acidemia (pH\u2009&lt;\u20097.0), 5-minute Apgar score &lt;4, and neonatal intensive care admission. Regression analyses controlling for known variables associated with neonatal acidemia generated adjusted odds ratios (aORs) with 95% confidence intervals (CIs).<\/jats:p><jats:p>\n            Results\u2003Among 9,088 deliveries during the study period, 1,162 tracings were flagged as persistent category II, including 681 (59%) in the postintervention group. The two cohorts had comparable baseline and obstetric characteristics. No difference in neonatal acidemia was observed between the postdeimplementation group and historical controls (13.8 vs. 15.4%, aOR\u2009=\u20090.87, 95% CI: 0.62, 1.22). Severe acidemia, 5-minute Apgar &lt;4, and neonatal intensive care admission were not increased in the postdeimplementation group.<\/jats:p><jats:p>\n            Conclusion\u2003De-implementation of routine maternal oxygen supplementation for fetal resuscitation did not increase the likelihood of neonatal acidemia in a real-world setting, validating guidelines recommending against the intervention.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2405-1687","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T23:35:36Z","timestamp":1724974536000},"page":"471-477","source":"Crossref","is-referenced-by-count":1,"title":["Deimplementation of Routine Maternal Oxygen Supplementation for Intrauterine Fetal Resuscitation: A Retrospective Cohort Study"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7397-5843","authenticated-orcid":false,"given":"Sarah E.","family":"Chisholm","sequence":"additional","affiliation":[{"name":"Ochsner Clinical School, Ochsner Health, Dartmouth-Hitchcock Pediatric Residency Program, University of Queensland, Herston, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariella","family":"Gastanaduy","sequence":"additional","affiliation":[{"name":"Ochsner Center for Outcome and Health Services Research, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrem","family":"Elmayan","sequence":"additional","affiliation":[{"name":"Ochsner Center for Outcome and Health Services Research, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7507-4870","authenticated-orcid":false,"given":"Frank B.","family":"Williams","sequence":"additional","affiliation":[{"name":"Section of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Ochsner Health, New Orleans, Louisiana"},{"name":"University of Queensland, Herston, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1097\/AOG.0b013e318289510d","article-title":"Electronic fetal monitoring in the United States: temporal trends and adverse perinatal outcomes","volume":"121","author":"C V Ananth","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/AOG.0b013e3181841395","article-title":"The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines","volume":"112","author":"G A Macones","year":"2008","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/AOG.0b013e3182004fa9","article-title":"Practice Bulletin No. 116: Management of intrapartum fetal heart rate tracings","volume":"116","author":"American College of Obstetricians and Gynecologists","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/0002-9378(75)90195-7","article-title":"The effect of increased maternal PaO2 upon the fetus during labor","volume":"123","author":"H O Morishima","year":"1975","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/0002-9378(67)90205-0","article-title":"Effects on fetal heart rate and fetal pO2 of oxygen administration to the mother","volume":"98","author":"O Althabe Jr","year":"1967","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"100102","DOI":"10.1016\/j.ajogmf.2020.100102","article-title":"The effect of intrauterine resuscitation by maternal hyperoxygenation on perinatal and maternal outcome: a randomized controlled trial","volume":"2","author":"S Moors","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"03","key":"ref7","first-page":"409","article-title":"Intrapartum Resuscitation Interventions for Category II Fetal Heart Rate Tracings and Improvement to Category I","volume":"138","author":"U M Reddy","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"09","key":"ref8","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1001\/jamapediatrics.2018.1208","article-title":"Effect of oxygen vs room air on intrauterine fetal resuscitation: a randomized noninferiority clinical trial","volume":"172","author":"N Raghuraman","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"905.e1","DOI":"10.1016\/j.ajog.2020.06.037","article-title":"The effect of intrapartum oxygen supplementation on category II fetal monitoring","volume":"223","author":"N Raghuraman","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ajog.2014.01.004","article-title":"Oxygen for intrauterine resuscitation: of unproved benefit and potentially harmful","volume":"211","author":"M S Hamel","year":"2014","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"2248","DOI":"10.1007\/s00134-020-06314-w","article-title":"Airborne spread of SARS-CoV-2 while using high-flow nasal cannula oxygen therapy: myth or reality?","volume":"46","author":"A Haymet","year":"2020","journal-title":"Intensive Care Med"},{"issue":"08","key":"ref12","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1055\/s-0040-1710308","article-title":"General guidelines in the management of an obstetrical patient on the labor and delivery unit during the COVID-19 pandemic","volume":"37","author":"A J Stephens","year":"2020","journal-title":"Am J Perinatol"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1097\/AOG.0b013e31822f1b50","article-title":"Frequency of fetal heart rate categories and short-term neonatal outcome","volume":"118","author":"M Jackson","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1055\/s-0041-1727214","article-title":"Unexpected term neonatal intensive care unit admissions and a potential role for centralized remote fetal monitoring","volume":"40","author":"J K Martin","year":"2023","journal-title":"Am J Perinatol"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1001\/jamapediatrics.2020.5351","article-title":"Maternal oxygen supplementation compared with room air for intrauterine resuscitation: a systematic review and meta-analysis","volume":"175","author":"N Raghuraman","year":"2021","journal-title":"JAMA Pediatr"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"440.e1","DOI":"10.1016\/j.ajog.2020.05.056","article-title":"The duration of intrapartum supplemental oxygen administration and umbilical cord oxygen content","volume":"223","author":"V Y Watkins","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"ref20","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1258\/jrsm.2011.110180","article-title":"The answer is 17 years, what is the question: understanding time lags in translational research","volume":"104","author":"Z S Morris","year":"2011","journal-title":"J R Soc Med"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1055\/s-0040-1721728","article-title":"Implementation science is imperative to the optimization of obstetric care","volume":"38","author":"R F Hamm","year":"2021","journal-title":"Am J Perinatol"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/0002-9378(72)90624-2","article-title":"Mechanism of late deceleration of the fetal heart rate","volume":"113","author":"L S James","year":"1972","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/0002-9378(82)90631-7","article-title":"Fetal heart rate accelerations and late decelerations during the course of intrauterine death in chronically catheterized rhesus monkeys","volume":"144","author":"Y Murata","year":"1982","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/0002-9378(71)90639-9","article-title":"Effects of maternal hyperoxia on the fetus. I. Oxygen tension","volume":"109","author":"A F Khazin","year":"1971","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2405-1687.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T23:31:52Z","timestamp":1740439912000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2405-1687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":21,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,2,24]]},"published-print":{"date-parts":[[2025,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2405-1687","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8,29]]},"published":{"date-parts":[[2024,8,29]]}}}