{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:47:23Z","timestamp":1777632443832,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Sigma Theta Tau International Theta Alpha Chapter"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Continuous electronic fetal monitoring (CEFM) is a standard of hospital care during the intrapartum period. We investigated its use on childbirth outcomes in low\u2010risk pregnancies, and examined whether outcomes differed by gestational age within a term pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective secondary data analysis using birth registry data from two diverse northeastern US states from 1992 to 2014. Chi\u2010square test and the Fisher exact tests were used to examine associations between CEFM and childbirth outcomes. Multivariable Poisson regression models were used to estimate risk ratios of childbirth outcomes related to CEFM use, adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Use of CEFM was independently associated with a 10% (State 1) and 40% (State 2) increased risk for primary cesarean delivery and an increased risk for assisted vaginal births (14% and 24%, respectively) after adjustment for confounders. CEFM use was not associated with reduced risk for infant mortality (neonatal mortality, 0\u201027\u00a0days, and post\u2010neonatal mortality, 28\u2010364\u00a0days) in term births (37\u201041\u00a0weeks\u2019 gestation). After stratifying term pregnancies into early term, full term, and late term, use of CEFM was associated with reduced risk for neonatal mortality in early\u2010term births (37 0\/7\u00a0weeks\u2019 to 38 6\/7\u00a0weeks\u2019 gestation) in State 2 (RR 0.44 [95% CI 0.21\u20100.92]), but not in State 1. There was no association between CEFM use and infant mortality (neonatal and post\u2010neonatal) in full\u2010term or late\u2010term births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study results do not support universal use of CEFM in pregnancies that are low\u2010risk and at term.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12422","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T17:16:39Z","timestamp":1551287799000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Impact of continuous electronic fetal monitoring on birth outcomes in low\u2010risk pregnancies"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2233-2554","authenticated-orcid":false,"given":"Lisa","family":"Heelan\u2010Fancher","sequence":"first","affiliation":[{"name":"College of Nursing and Health Sciences University of Massachusetts Boston Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-813X","authenticated-orcid":false,"given":"Ling","family":"Shi","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences University of Massachusetts Boston Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences University of Massachusetts Boston Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yurun","family":"Cai","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences University of Massachusetts Boston Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ampicha","family":"Nawai","sequence":"additional","affiliation":[{"name":"Boromarajonani College of Nursing Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-1580","authenticated-orcid":false,"given":"Suzanne","family":"Leveille","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences University of Massachusetts Boston Boston Massachusetts"},{"name":"Division of General Medicine and Primary Care Beth Israel Deaconess Medical Center, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Hospitalizations Related to Childbirth, 2006","author":"Russo C","year":"2009"},{"issue":"12","key":"e_1_2_5_3_1","first-page":"311","article-title":"Births: final data for 2014","volume":"64","author":"Hamilton BE","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181aef106"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1891\/1058-1243.22.3.156"},{"issue":"1","key":"e_1_2_5_6_1","first-page":"6","article-title":"The fetal electrocardiogram: measuring technics","volume":"24","author":"Hon E","year":"1963","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.69.9.864"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.04.024"},{"issue":"2","key":"e_1_2_5_9_1","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labor","author":"Alfirevic Z","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_10_1","first-page":"369","article-title":"Neonatal outcome associated with singleton birth at 34\u201341 weeks of gestation","volume":"39","author":"Gouyon JB","year":"2010","journal-title":"J Epidemiol"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-62"},{"issue":"11","key":"e_1_2_5_12_1","first-page":"1053","article-title":"Adverse neonatal outcomes associated with early term birth","volume":"167","author":"Sengupta S","year":"2013","journal-title":"J Am Med Assoc"},{"key":"e_1_2_5_13_1","unstructured":"Child Health USA 2011.Neonatal and post\u2010neonatal mortality. 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