title: Correlation between fetal heart rate reactivity and mortality and severe neurological morbidity in extremely low birth weight infants.
abstract: OBJECTIVE
  To determine the correlation between specific fetal heart rate (FHR) abnormalities and the incidence of death, severe (grade 3-4) intraventricular hemorrhage (IVH) and periventricular echogenicity (PVE) in extremely low birth weight infants (ELBW) within the first 4 days after birth.
  
  
  METHODS
  The study included live-born ELBW infants ≤ 30 weeks' gestation who were born in 2000-2007 at Kaplan Medical Center, Rehovot, Israel, and, who had FHR monitoring during the 24 h before delivery and cranial ultrasound during the first 4 days of life. FHR pattern was analyzed for the presence of baseline rate, reactivity, variability and decelerations.
  
  
  RESULTS
  96 infants with mean birth weight 757 ± 150 g and mean gestational age 25.8 ± 1.5 weeks were included. By 4 days of life, 23/96 (24%) died, 17/96 (18%) developed severe IVH and 31/96 (32%) had PVE. Absence of reactivity was significantly associated with increase in both death (p = 0.02, OR 3.45, 95% CI: 1.22-9.47 and severe IVH (p = 0.029, OR 3.33, 95% CI: 1.25-10) but not with PVE. Other FHR parameters were not associated with adverse outcome.
  
  
  CONCLUSIONS
  These results suggest that FHR reactivity may be of value in predicting short-term outcome in ELBW infants. This may be helpful in counseling parents with imminent extremely preterm birth.
authors.affiliation: Department of Neonatology, Kaplan Medical Center, Rehovot and Hebrew University, Jerusalem, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Eventov-Friedman
authors.forename: E S
authors.initials: ES
authors.lastname: Shinwell
authors.forename: E
authors.initials: E
authors.lastname: Barnea
authors.forename: O
authors.initials: O
authors.lastname: Flidel-Rimon
authors.forename: A
authors.initials: A
authors.lastname: Juster-Reicher
authors.forename: R
authors.initials: R
authors.lastname: Levy
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D003643:Death; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D009017:Morbidity; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000401:mortality; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult