Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China
ObjectiveThis study aimed to identify various perinatal maternal characteristics that contributed to neonatal asphyxia (NA) in term and late-preterm newborns based on the data obtained from a Chinese birth registry cohort and to establish an effective model for predicting a high risk of asphyxia.Met...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.944272/full |
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| author | Yi Yu Yi Yu Jinsong Gao Jinsong Gao Juntao Liu Juntao Liu Yabing Tang Mei Zhong Jing He Shixiu Liao Xietong Wang Xinghui Liu Yinli Cao Caixia Liu Jingxia Sun |
| author_facet | Yi Yu Yi Yu Jinsong Gao Jinsong Gao Juntao Liu Juntao Liu Yabing Tang Mei Zhong Jing He Shixiu Liao Xietong Wang Xinghui Liu Yinli Cao Caixia Liu Jingxia Sun |
| author_sort | Yi Yu |
| collection | DOAJ |
| description | ObjectiveThis study aimed to identify various perinatal maternal characteristics that contributed to neonatal asphyxia (NA) in term and late-preterm newborns based on the data obtained from a Chinese birth registry cohort and to establish an effective model for predicting a high risk of asphyxia.MethodWe retrospectively reviewed and analyzed the birth database from July 1, 2016, to June 30, 2017, in the main economically developed regions of China. Asphyxia was defined as an Apgar score <7 at 5 min post-delivery with umbilical cord arterial blood pH < 7.2 in the infant born after 34weeks. We compared the perinatal maternal characteristics of the newborns who developed asphyxia (NA group, n = 1,152) and those who did not (no NA group, n = 86,393). Candidate predictors of NA were analyzed using multivariable logistic regression. Subsequently, a prediction model was developed and validated by an independent test group.ResultOf the maternal characteristics, duration of PROM ≥ 48 h, a gestational week at birth <37, prolonged duration of labor, hypertensive disorder, nuchal cord, and birth weight <2,500 or ≥4,000 g, abnormal fetal heart rate, meconium-stained amniotic fluid, and placenta previa were included in the predicting model, which presented a good performance in external validation (c-statistic of 0.731).ConclusionOur model relied heavily on clinical predictors that may be determined before or during birth, and pregnant women at high risk of NA might be recognized earlier in pregnancy and childbirth using this methodology, allowing them to avoid being neglected and delayed. Future studies should be conducted to assess its usefulness. |
| first_indexed | 2024-04-13T11:14:25Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T11:14:25Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-815a8571eb0341dab416d87b269ce2472022-12-22T02:49:01ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.944272944272Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in ChinaYi Yu0Yi Yu1Jinsong Gao2Jinsong Gao3Juntao Liu4Juntao Liu5Yabing Tang6Mei Zhong7Jing He8Shixiu Liao9Xietong Wang10Xinghui Liu11Yinli Cao12Caixia Liu13Jingxia Sun14Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics & Gynecologic Diseases, Peking Union Medical College Hospital (CAMS), Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics & Gynecologic Diseases, Peking Union Medical College Hospital (CAMS), Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics & Gynecologic Diseases, Peking Union Medical College Hospital (CAMS), Beijing, ChinaDepartment of Obstetrics and Gynecology, Hunan Maternal and Child Health Care Hospital, Changsha, ChinaDepartment of Obstetrics and Gynecology, Nanfang Hospital Southern Medical University, Guangzhou, ChinaDepartment of Obstetrics and Gynecology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Obstetrics and Gynecology, Henan Provincial People's Hospital Zhengzhou, Henan, ChinaDepartment of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, ChinaDepartment of Obstetrics and Gynecology, Sichuan University West China Second Hospital, Chengdu, ChinaDepartment of Obstetrics and Gynecology, Northwest Women and Children's Hospital, Xi'an, China0Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, China1Department of Obstetrics and Gynecology, The First Clinical Hospital Affiliated to Harbin Medical University, Harbin, ChinaObjectiveThis study aimed to identify various perinatal maternal characteristics that contributed to neonatal asphyxia (NA) in term and late-preterm newborns based on the data obtained from a Chinese birth registry cohort and to establish an effective model for predicting a high risk of asphyxia.MethodWe retrospectively reviewed and analyzed the birth database from July 1, 2016, to June 30, 2017, in the main economically developed regions of China. Asphyxia was defined as an Apgar score <7 at 5 min post-delivery with umbilical cord arterial blood pH < 7.2 in the infant born after 34weeks. We compared the perinatal maternal characteristics of the newborns who developed asphyxia (NA group, n = 1,152) and those who did not (no NA group, n = 86,393). Candidate predictors of NA were analyzed using multivariable logistic regression. Subsequently, a prediction model was developed and validated by an independent test group.ResultOf the maternal characteristics, duration of PROM ≥ 48 h, a gestational week at birth <37, prolonged duration of labor, hypertensive disorder, nuchal cord, and birth weight <2,500 or ≥4,000 g, abnormal fetal heart rate, meconium-stained amniotic fluid, and placenta previa were included in the predicting model, which presented a good performance in external validation (c-statistic of 0.731).ConclusionOur model relied heavily on clinical predictors that may be determined before or during birth, and pregnant women at high risk of NA might be recognized earlier in pregnancy and childbirth using this methodology, allowing them to avoid being neglected and delayed. Future studies should be conducted to assess its usefulness.https://www.frontiersin.org/articles/10.3389/fmed.2022.944272/fullpredictive modelneonatal asphyxiarisk factorsfetal distresscohort study |
| spellingShingle | Yi Yu Yi Yu Jinsong Gao Jinsong Gao Juntao Liu Juntao Liu Yabing Tang Mei Zhong Jing He Shixiu Liao Xietong Wang Xinghui Liu Yinli Cao Caixia Liu Jingxia Sun Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China Frontiers in Medicine predictive model neonatal asphyxia risk factors fetal distress cohort study |
| title | Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China |
| title_full | Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China |
| title_fullStr | Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China |
| title_full_unstemmed | Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China |
| title_short | Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China |
| title_sort | perinatal maternal characteristics predict a high risk of neonatal asphyxia a multi center retrospective cohort study in china |
| topic | predictive model neonatal asphyxia risk factors fetal distress cohort study |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.944272/full |
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