{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:57:56Z","timestamp":1767650276340,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5\u2010tier cardiotocography classification are limited. This study aimed to determine the correlation between 5\u2010tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology. Apgar scores and perinatal prognosis were compared between patients with Japan Society of Obstetrics and Gynecology intrapartum cardiotocography levels 1\u20132, and levels 3\u20135.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 240\u2009987 cases were registered, with 114\u2009201 full\u2010term deliveries comprising 84\u2009703 vaginal and 29\u2009498 cesarean deliveries. For vaginal delivery cases, the crude odds ratios of 1\u2010min Apgar score\u2009\u22643 for levels 3 (odds ratio: 1.7, 95% confidence interval: 1.4\u20132.0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), levels 4 (odds ratio: 5.9, 95% confidence interval: 5.1\u20136.9, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and levels 5 (odds ratio: 49.2, 95% confidence interval: 37.5\u201364.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) were significantly higher than those for levels 1\u20132 (odds ratio: 1.0). Moreover, the crude odds ratios of 5\u2010min Apgar score\u2009\u2264\u20093 for levels 4 (odds ratio: 4.8, confidence interval: 2.7\u20138.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and levels 5 (odds ratio: 71.1, confidence interval: 32.6\u2013155.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) were significantly higher than those for levels 1\u20132 (odds ratio: 1.0). Similarly, in cases of cesarean delivery, it showed a similar trend to case of vaginal delivery cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The 5\u2010tier cardiotocography classification can predict severe neonatal asphyxia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.16199","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T04:14:12Z","timestamp":1735618452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation between the 5\u2010tier fetal heart rate pattern classification at delivery and Apgar scores"],"prefix":"10.1111","volume":"51","author":[{"given":"Mariko","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Yamagata University Faculty of Medicine  Yamagata Yamagata 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