Does maternal race influence the short-term variation of the fetal heart rate? An historical cohort study.
OBJECTIVE
The main aim of this article was to analyze short-term variation (STV) of the fetal heart rate according to maternal race. The secondary aim was to study the baseline fetal heart rate according to this factor.


METHODS
This single-center historical cohort study covered the period from November 2008 through December 2011 (n=182). The inclusion criteria were: black women from sub-Saharan Africa or white European women, with a singleton pregnancy ≥34 weeks and fetal heart rate recorded by computerized analysis (Oxford Sonicaid System 8002) at a prenatal visit. The exclusion criteria were: medication likely to modify fetal heart rate, abnormal fetal heart rate tracing, and being in labor. A multiple linear regression analysis was used to study the association between maternal race and STV.


RESULTS
STV was lower by 2.6ms in fetuses of black women (n=55) compared to those of white women (n=127) (8.9±2.1ms vs. 11.4±3.4ms) (p<0.001). The basal fetal heart rate was higher (p=0.001), and the recording criteria were met less often for the black women (p=0.04). After adjustment for maternal age, body mass index at the beginning of pregnancy, maternal cigarette smoking, parity, gestational diabetes, gestational age at the time of the fetal heart rate recording, and the time between the last meal and the recording, mean STV was lower by 3.1±0.6ms in fetuses of black compared with white women (p<0.001).


CONCLUSIONS
STV is lower in fetuses of black women compared to those of white women in a low-risk population. A study of black and white women with high-risk pregnancies is necessary to assess the impact of medical practices on perinatal outcome after STV analysis.
Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert 63000, Clermont-Ferrand Cedex 1 63003, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France. Electronic address: cmarie@chu-clermontferrand.fr.
Cécile
C
Marie
Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert 63000, Clermont-Ferrand Cedex 1 63003, France.
Céline
C
Sinoquet
Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert 63000, Clermont-Ferrand Cedex 1 63003, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France.
Chloé
C
Barasinski
Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert 63000, Clermont-Ferrand Cedex 1 63003, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France; AUDIPOG (Association des Utilisateurs de Dossiers informatisés en Pédiatrie, Obstétrique et Gynécologie), RTH Laennec Medical University, 7 rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
Didier
D
Lémery
Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert 63000, Clermont-Ferrand Cedex 1 63003, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France; AUDIPOG (Association des Utilisateurs de Dossiers informatisés en Pédiatrie, Obstétrique et Gynécologie), RTH Laennec Medical University, 7 rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
Françoise
F
Vendittelli
D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D044383:Black People; D015148:Cardiotocography; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D012815:Signal Processing, Computer-Assisted; D044465:White People; D055815:Young Adult
Computerized cardiotocography; Electronic fetal heart rate monitoring; Fetal heart rate variation; Fetal monitoring interpretation; Patient safety