{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:58:46Z","timestamp":1790218726258,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,4,15]],"date-time":"2018-04-15T00:00:00Z","timestamp":1523750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004921","name":"Shanghai Jiao Tong University","doi-asserted-by":"publisher","award":["YG2016MS41"],"award-info":[{"award-number":["YG2016MS41"]}],"id":[{"id":"10.13039\/501100004921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to identify fetal heart rate (<jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content>) characteristics that are associated with neonatal encephalopathy (<jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective case\u2010control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A single medical centre in Shanghai, China, 2006\u20132015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Women delivering a singleton, non\u2010anomalous infant at \u226536 weeks\u2019 gestation diagnosed with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> (cases, <jats:italic>n<\/jats:italic> = 109) were compared with a group of women with unaffected infants (controls, <jats:italic>n<\/jats:italic> = 233).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two physicians blinded to the outcome independently reviewed <jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content> tracings during the last 30 minutes of tracing prior to delivery. <jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content> characteristics were compared in the two groups and multivariable logistic regression was used to adjust for confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Adjusted odds ratio (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>) and 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) for the presence of specific <jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content> categories and characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Category <jats:styled-content style=\"fixed-case\">II FHR<\/jats:styled-content> tracings were observed in 89% of women prior to delivery and were not independently associated with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>. Notably, a category <jats:styled-content style=\"fixed-case\">III FHR<\/jats:styled-content> was observed in 17.4% of women in the <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> group compared with 0.9% of women in the control group (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 44.99, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.23\u2013279.97). Bradycardia, minimal\/absent variability, late decelerations and prolonged decelerations were independently associated with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>, whereas accelerations were protective. Similar findings were found when the cases were limited to <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> with arterial cord <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> &lt;7.1 and in a subgroup analysis of women with category <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> tracings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Category <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> tracings, while infrequent, are not uncommon prior to delivery among fetuses who develop <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>. In contrast, most <jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content> tracings are category <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> prior to delivery; however, individual <jats:styled-content style=\"fixed-case\">FHR<\/jats:styled-content> characteristics within this category are associated with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Funding<\/jats:title><jats:p>This research was supported by the Interdisciplinary Programme of Shanghai Jiao Tong University.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Category <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> tracings are not uncommon prior to delivery among fetuses who develop neonatal encephalopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15222","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T15:18:04Z","timestamp":1521991084000},"page":"1480-1487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["An evaluation of fetal heart rate characteristics associated with neonatal encephalopathy: a case\u2010control study"],"prefix":"10.1111","volume":"125","author":[{"given":"HA","family":"Frey","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics International Peace Maternity &amp; Child Health Hospital Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CD","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Musindi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Samuels","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KM","family":"Rood","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SF","family":"Thung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JM","family":"Bakk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics International Peace Maternity &amp; 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