{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:17:34Z","timestamp":1789186654571,"version":"build-2803163510"},"reference-count":63,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Stacey and Steven Hoffman Clinical Care Innovations Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Neonatal early onset sepsis (EOS), bacterial infection during the first seven days of life, is difficult to diagnose because presenting signs are non-specific, but early diagnosis before birth can direct life-saving treatment for mother and baby. Specifically, maternal fever during labor from placental infection is the strongest predictor of EOS. Alterations in maternal heart rate variability (HRV) may precede development of intrapartum fever, enabling incipient EOS detection. The objective of this work was to build a predictive model for intrapartum fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Continuously measured temperature, heart rate, and beat-to-beat RR intervals were obtained from wireless sensors on women ( n\u2009=\u2009141) in labor; traditional manual vital signs were taken every 3\u20136\u2005hours. Validated measures of HRV were calculated in moving 5-minute windows of RR intervals: standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD) between normal heartbeats.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fever (&gt;38.0\u2005\u00b0C) was detected by manual or continuous measurements in 48 women. Compared to afebrile mothers, average SDNN and RMSSD in febrile mothers decreased significantly ( p\u2009&lt;\u20090.001) at 2 and 3\u2005hours before fever onset, respectively. This observed HRV divergence and raw recorded vitals were applied to a logistic regression model at various time horizons, up to 4\u20135\u2005hours before fever onset. Model performance increased with decreasing time horizons, and a model built using continuous vital signs as input variables consistently outperformed a model built from episodic vital signs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HRV-based predictive models could identify mothers at risk for fever and infants at risk for EOS, guiding maternal antibiotic prophylaxis and neonatal monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076231187594","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T02:49:45Z","timestamp":1688957385000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prediction of intrapartum fever using continuously monitored vital signs and heart rate variability"],"prefix":"10.1177","volume":"9","author":[{"given":"Shubham","family":"Debnath","sequence":"first","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA"},{"name":"Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Koppel","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, NY, USA"},{"name":"Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Queens, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafeesa","family":"Saadi","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Queens, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Potak","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Queens, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, NY, USA"},{"name":"Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Queens, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-9551","authenticated-orcid":false,"given":"Theodoros P","family":"Zanos","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA"},{"name":"Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA"},{"name":"Donald and Barbara 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