title: Computer analysis of maternal-fetal heart rate recordings during labor in relation with maternal-fetal attachment and prediction of newborn acidemia.
abstract: OBJECTIVE
  To assess combined maternal (MHR) and fetal heart rate (FHR) recordings during labor, in relation with maternal-fetal attachment and prediction of newborn acidemia.
  
  
  METHODS
  Fifty-nine simultaneous MHR and FHR recordings were acquired in the final minutes of labor. Computer analysis followed the FIGO guidelines with estimation of MHR and FHR baselines, accelerations, decelerations, short- (STV) and long-term variabilities. MHR and FHR characteristics, their differences and correlations were assessed in relation to labor progression and to newborn umbilical artery blood (UAB) pH lower than 7.15 and 7.20. To assess prediction of acidemia, areas under ROC curves (auROC) were calculated.
  
  
  RESULTS
  Progression of labor was associated with a significant increase in MHR accelerations and FHR decelerations both in the non-acidemic and acidemic fetuses (p < 0.01). At the same time there was an increase in MHR-FHR correlations and differences in accelerations and decelerations in acidemic fetuses. The auROC ranged between 0.50 for FHR accelerations and 0.77 for MHR baseline plus FHR STV.
  
  
  CONCLUSIONS
  MHR and FHR respond differently during labor with signs of increased maternal-fetal attachment during labor progression in acidemic fetuses. Combined MHR-FHR analysis may help to improve prediction of newborn acidemia compared with FHR analysis alone.
authors.affiliation: a Serviço de Ginecologia e Obstetrícia, Hospital Nélio Mendonça , Funchal , Portugal .|b Departamento de Obstetrícia e Ginecologia , Faculdade de Medicina da Universidade do Porto , Porto , Portugal .
authors.forename: Paula
authors.initials: P
authors.lastname: Pinto
authors.affiliation: c CINTESIS -- Centre for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto , Porto , Portugal .
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa-Santos
authors.affiliation: b Departamento de Obstetrícia e Ginecologia , Faculdade de Medicina da Universidade do Porto , Porto , Portugal .|d Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São João , Porto , Portugal .|e INEB -- Institute of Biomedical Engineering , Porto , Portugal , and.
authors.forename: Diogo
authors.initials: D
authors.lastname: Ayres-de-Campos
authors.affiliation: b Departamento de Obstetrícia e Ginecologia , Faculdade de Medicina da Universidade do Porto , Porto , Portugal .|c CINTESIS -- Centre for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto , Porto , Portugal .|d Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São João , Porto , Portugal .|f Departamento da Mulher, do Jovem e da Criança , Hospital Pedro Hispano, Unidade Local de Saude de Matosinhos , Matosinhos , Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Bernardes
mesh_terms: D000137:Acid-Base Imbalance / Q000453:epidemiology*; D000328:Adult; D015148:Cardiotocography; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D033261:Maternal-Fetal Relations; D011174:Portugal / Q000453:epidemiology; D055815:Young Adult
keywords: Attachment; FIGO guidelines; cardiotocography; computer analysis; fetal heart rate; maternal heart rate; prediction