{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:20:43Z","timestamp":1782516043919,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Adjunctive technologies to cardiotocography intend to increase the specificity of the diagnosis of fetal hypoxia. If correctly diagnosed, time to delivery could affect neonatal outcome. In the present study, we aimed to investigate the effect of time from when fetal distress is indicated by a high fetal blood sample (FBS) lactate concentration to operative delivery on the risk of adverse neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We conducted a prospective observational study. Deliveries with a singleton fetus in cephalic presentation at 36<jats:sup>+0<\/jats:sup>weeks of gestation or later were included. Adverse neonatal outcomes, related to decision\u2010to\u2010delivery interval (DDI), were investigated in operative deliveries indicated by an FBS lactate concentration of at least 4.8\u2009mmol\/L. We applied logistic regression to estimate crude and adjusted odds ratios (aOR) of various adverse neonatal outcomes, with associated 95% confidence intervals (CI), for a DDI exceeding 20\u2009minutes, compared with a DDI of 20\u2009minutes or less. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT04779294.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The main analysis included 228 women with an operative delivery indicated by an FBS lactate concentration of 4.8\u2009mmol\/L or greater. The risk of all adverse neonatal outcomes was significantly increased for both DDI groups compared with the reference group (deliveries with an FBS lactate below 4.2\u2009mmol\/L within 60\u2009minutes before delivery). In operative deliveries indicated by an FBS lactate concentration of 4.8\u2009mmol\/L or more, there was a significantly increased risk of a 5\u2010minute Apgar score less than 7 if the DDI exceeded 20\u2009minutes, compared with a DDI of 20\u2009minutes or less (aOR 8.1, 95% CI 1.1\u201360.9). We found no statistically significant effect on other short\u2010term outcomes for deliveries with DDI longer than 20\u2009minutes, compared with those with DDI of 20\u2009minutes or less (pH \u22647.10: aOR 2.0, 95% CI 0.5\u20138.4; transfer to the neonatal intensive care unit: aOR 1.1, 95% CI 0.4\u20133.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After a high FBS lactate measurement, the increased risk of adverse neonatal outcome is further augmented if the DDI exceeds 20\u2009minutes. These findings give support to current Norwegian guidelines for intervention in cases of fetal distress.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14597","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T05:54:17Z","timestamp":1686203657000},"page":"1106-1114","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Neonatal outcomes associated with time from a high fetal blood lactate concentration to operative delivery"],"prefix":"10.1111","volume":"102","author":[{"given":"Magnus B.","family":"Berge","sequence":"first","affiliation":[{"name":"Division of Gynecology and Obstetrics Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2931-2668","authenticated-orcid":false,"given":"J\u00f8rg","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Haukeland University Hospital  Bergen Norway"},{"name":"Department of Clinical Science University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Branka M.","family":"Yli","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Cathrine","family":"Staff","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Gunnes","sequence":"additional","affiliation":[{"name":"Norwegian Research Center for Women's Health University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8545-5156","authenticated-orcid":false,"given":"Anne Flem","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"StatPearls","author":"Gillam\u2010Krakauer M","year":"2022"},{"issue":"2","key":"e_1_2_12_3_1","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour","volume":"2017","author":"Alfirevic Z","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181aef106"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199603073341001"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(67)90515-7"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb10878.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12923"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.04.003"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107680009300703"},{"key":"e_1_2_12_11_1","volume-title":"National Institute for health and care excellence: clinical guidelines. 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