{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:59:01Z","timestamp":1790218741701,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/13\/13\/30194; RG\/18\/13\/33946"],"award-info":[{"award-number":["RG\/13\/13\/30194; RG\/18\/13\/33946"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["BRC\u20101215\u201020014"],"award-info":[{"award-number":["BRC\u20101215\u201020014"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the hypothesis that risk factors in addition to an abnormal fetal heart rate pattern (aFHRp) are independently associated with adverse neonatal outcomes of labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>17 <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> maternity units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>585\u2009291 pregnancies between 1988 and 2000 inclusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adjusted odds ratios (OR) with 95% confidence intervals (95% CI) were estimated from multivariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Adverse neonatal outcome at term (5\u2010minute Apgar score\u2009&lt;7, and a composite measure comprising 5\u2010minute Apgar score\u2009&lt;7, resuscitation by intubation and\/or perinatal death).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis was based on 302\u2009137 vaginal births at 37\u201342\u2009weeks inclusive. We found a higher odds of Apgar score at 5\u2009minutes &lt;7 with suspected fetal growth restriction (OR 1.34, 95% CI 1.16\u20131.53), induction of labour (OR 1.41, 95% CI 1.25\u20131.58), nulliparity (OR 1.48, 95% CI 1.34\u20131.63), booking body mass index \u226530 (OR 1.18, 95% CI 1.02\u20131.37), maternal age &lt;25 (OR 1.23, 95% CI 1.10\u20131.39), black ethnicity (OR 1.21, 95% CI 1.03\u20131.43), early\u2010term birth at 37\u201338\u2009weeks (OR 1.13, 95% CI 1.02\u20131.25), late\u2010term birth at 41\u201342\u2009weeks (OR 1.14, 95% CI 1.01\u20131.28), use of oxytocin (OR 1.27, 95% CI 1.14\u20131.41), maternal pyrexia (OR 1.87, 95% CI 1.46\u20132.40), aFHRp and presence of meconium (aFHRp without meconium: OR 2.40, 95% CI 2.15\u20132.69; meconium without aFHRp: OR 2.20, 195% CI.94\u20132.49; both aFHRp and meconium: OR 4.26, 95% CI 3.74\u20134.87). The results were similar when the composite adverse outcome was considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A range of risk factors, including suspicion of fetal growth restriction, maternal pyrexia and presence of meconium, are implicated in poor birth outcomes in addition to aFHRp. Interpretation of the fetal heart rate pattern alone is insufficient as a basis for decisions about escalation and intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17531","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T02:54:46Z","timestamp":1683600886000},"page":"1521-1530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Risk factors for a serious adverse outcome in neonates: a retrospective cohort study of vaginal births"],"prefix":"10.1111","volume":"130","author":[{"given":"Sita","family":"Jindal","sequence":"first","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology Imperial College London, Chelsea and Westminster Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip J.","family":"Steer","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology Imperial College London, Chelsea and Westminster Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makrina","family":"Savvidou","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology Imperial College London, Chelsea and Westminster Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Draycott","sequence":"additional","affiliation":[{"name":"The Royal College of Obstetricians and Gynaecologists  London UK"},{"name":"Department of Women's Health North Bristol NHS Trust  Westbury on Trym UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Dixon\u2010Woods","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care University of Cambridge, Strangeways Research Laboratory  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care \/ Cardiovascular Epidemiology Unit, Victor Phillip Dahdaleh Heart and Lung Research Institute University of Cambridge  Cambridge UK"},{"name":"Health Data Research UK Cambridge Wellcome Genome Campus and University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois G.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care \/ Cardiovascular Epidemiology Unit, Victor Phillip Dahdaleh Heart and Lung Research Institute University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"MagroM.Five years of cerebral palsy claims. 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