title: Fetal heart rate patterns and neurodevelopmental outcome in very low birth weight infants.
abstract: BACKGROUND
  To evaluate the validity of fetal heart rate monitoring during the last hour prior to birth, as a predictor of long term neurodevelopmental outcome of very low birth weight infants.
  
  
  METHODS
  A total of 111 very low birth weight infants were included in the study. Fetal heart rate tracings were obtained during the last hour prior to delivery. A perinatologist, blinded to the neonatal outcome, evaluated the tracings and divided them into three groups: reassuring, nonreassuring, and pathological. Neurodevelopmental status was evaluated at age 2 years. The relationship between fetal heart rate monitoring results and the neurodevelopmental outcome at 2 years of age was assessed with a chi-square test and the Student's t-test.
  
  
  RESULTS
  At 2 years of age 97 (87.4%) of the children had normal neurodevelopmental function, while 14 (12.6%) had variable degrees of neurodevelopmental impairment. The fetal heart rate monitoring results were classified as reassuring (normal) in 35 cases (31.5%), nonreassuring in 56 cases (50.5%), and pathological in 20 cases (18.0%). Both normal and pathological fetal heart rate patterns were associated with similar incidence of abnormal neurodevelopmental outcome, 14.3% and 15.0% of cases, respectively (p=0.778). Pathological fetal heart rate patterns as a predictor of neurodevelopmental outcome had a sensitivity of 27%, specificity of 74%, positive predictive value of 15%, and negative predictive value of 86%.
  
  
  CONCLUSIONS
  Electronic fetal heart rate monitoring prior to delivery is not a reliable tool for the prediction of neurodevelopmental impairment in premature infants of very low birth weight, at 2 years of age.
authors.affiliation: Department of Obstetrics and Gynecology, Binai-Zion Medical Center and Rapport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. vnisenblat@gmail.com
authors.forename: Vicki
authors.initials: V
authors.lastname: Nisenblat
authors.forename: Eran
authors.initials: E
authors.lastname: Alon
authors.forename: Shlomi
authors.initials: S
authors.lastname: Barak
authors.forename: Ron
authors.initials: R
authors.lastname: Gonen
authors.forename: David
authors.initials: D
authors.lastname: Bader
authors.forename: Gonen
authors.initials: G
authors.lastname: Ohel
mesh_terms: D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007743:Labor, Obstetric; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity