Journal of Perinatal Medicine最新文献

{"title":"Trends and variations in admissions for cannabis use disorder among pregnant women in United States.","authors":"Maria C Mejia, Lea Sacca, Allison H Ferris, Charles H Hennekens, Panagiota Kitsantas","doi":"10.1515/jpm-2024-0487","DOIUrl":"https://doi.org/10.1515/jpm-2024-0487","url":null,"abstract":"<p><strong>Objectives: </strong>Cannabis use disorder (CUD) among pregnant women is increasing, yet limited information exists on admissions for treatment in this population. This study examined trends in CUD admissions among pregnant women in publicly funded U.S. treatment facilities from 2000 to 2021.</p><p><strong>Methods: </strong>Using the Treatment Episode Data Set-Admissions, we analyzed 33,729 admissions of pregnant women with CUD. Descriptive statistics were used to assess patterns by race/ethnicity, age, and co-substance use.</p><p><strong>Results: </strong>CUD admissions increased 2.7-fold, from 2.3 % in 2000 to 6.2 % in 2009, followed by a decrease to 4.3 % in 2014, a peak of 6.7 % in 2018, and a decline to 3.0 % in 2021. In 2021, racial/ethnic disparities were noted, with higher proportions of admissions among White (48.8 %) and Black (32.5 %) non-Hispanic women compared to Hispanic women (9.6 %). Admissions decreased for women aged ≤20 years old (y/o), but increased for women aged ≥30 y/o from 2010 to 2021, with the highest prevalence in those aged 21-29 y/o. Co-substance use, particularly narcotics, stimulants, depressants, and hallucinogens, was prevalent from 2017 to 2021.</p><p><strong>Conclusions: </strong>CUD admissions among pregnant women have fluctuated over two decades, with variations by race/ethnicity and age. These findings highlight the need for tailored interventions and ongoing adaptation of treatment services for pregnant women with CUD.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective termination: a life-saving procedure for complicated monochorionic gestations.","authors":"Ali Javinani, Ramesha Papanna, Tim Van Mieghem, Julie S Moldenhauer, Anthony Johnson, Enrico Lopriore, Amos Grünebaum, Frank A Chervenak, Alireza A Shamshirsaz","doi":"10.1515/jpm-2024-0386","DOIUrl":"https://doi.org/10.1515/jpm-2024-0386","url":null,"abstract":"<p><p>Monochorionic twin pregnancies are a subset of twin pregnancies that face potential complications related to a shared circulation between the fetuses. These complications are related to anastomotic placental vessels connecting the cardiovascular systems of the two fetuses, which can result in significant sequela if one twin experiences intrauterine death. The sudden cardiovascular collapse in this scenario leads to a massive blood shift away from the healthy co-twin, significantly jeopardizing its life and long-term neurodevelopmental outcome. Such conditions include selective fetal growth restriction with abnormal Doppler findings, twin-twin transfusion with impending death in one twin and discordant fetal anomalies, for which fetal interventions are ineffective in improving outcomes or preventing the imminent death of the abnormal twin. Obstetricians have a professional obligation to respect the autonomy of pregnant patients and to maximize beneficence-based obligations to both pregnant and fetal patients. The goal of a selective termination is to maximize the health and life of the surviving fetal patient. It is recommended that policymakers consider including selective termination as an exemption to abortion ban laws.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal short-term outcome after vaginal breech delivery >36 weeks of gestation with and without MRI-based pelvimetric measurements: a Hannover retrospective cohort study.","authors":"Sabine K Maschke, Lena Steinkasserer, Diane Renz, Constantin von Kaisenberg, Peter Hillemanns, Lars Brodowski","doi":"10.1515/jpm-2024-0173","DOIUrl":"https://doi.org/10.1515/jpm-2024-0173","url":null,"abstract":"<p><strong>Objectives: </strong>Planning the mode of delivery of a full-term breech singleton remains a challenging task. The aim of this work is to compare the neonatal and maternal short-term outcomes after planned vaginal delivery and caesarean section and to evaluate the influence of an MRI pelvimetry on the short-term outcomes in order to provide appropriate advice to pregnant women with breech presentation.</p><p><strong>Methods: </strong>This is a retrospective monocentric analysis of all deliveries with singleton pregnancies from breech presentation >36 + 0 weeks of gestation between 08/2021 and 09/2023. Short-term maternal and neonatal morbidity data were collected for intended vaginal deliveries and caesarean sections. Neonatal and maternal short-term outcomes of intended vaginal deliveries with and without MRI pelvimetry were compared.</p><p><strong>Results: </strong>In the planned vaginal delivery group, APGAR scores and arterial umbilical cord pH were significantly lower than in the planned caesarean group. The rate of asphyxia was similar in both groups. Although not significant, the rate of NICU admission was higher in the vaginal birth group (6.7 % vs. 2.7 %; p=0.27), and infants born by caesarean remained in the NICU longer (1.3 % vs. 1.8 %; p=1.0). Neonates born to women who underwent MRI prior to attempted vaginal delivery had better short-term neonatal outcomes and shorter NICU stays compared with women who did not undergo MRI, after multivariate analysis for fetal birth weight, parity, and gestational age.</p><p><strong>Conclusions: </strong>Vaginal breech delivery is associated with lower APGAR scores and umbilical arterial pH compared with caesarean section but does not result in increased neonatal asphyxia or NICU admission. Length of stay in the NICU is shorter when a newborn is admitted after vaginal delivery. MRI pelvimetry may improve the outcome of the newborn by further selection.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve for the perinatal outcomes of radiofrequency ablation for selective fetal reduction: a single-center, 10-year experience from 2013 to 2023.","authors":"Shuang Li, Yu Sun, Zhe Liu","doi":"10.1515/jpm-2024-0201","DOIUrl":"10.1515/jpm-2024-0201","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the perinatal outcomes of SR using radiofrequency ablation (RFA) in MC pregnancies, identified factors affecting these outcomes, and assessed the associated learning curve.</p><p><strong>Methods: </strong>This retrospective cohort study included all consecutive MC pregnancies that required RFA from September 2013 to April 2023 at our institution. The perinatal outcomes were compared on the basis of various indications, and binary logistic regression analysis was performed to identify the risk factors for cotwin loss. Clinical datas of two periods (2013-2018 vs. 2019-2023) were compared to demonstrate the learning curve.</p><p><strong>Results: </strong>The 107 cases composed of 40 (37.4 %) twin-twin transfusion syndrome (TTTS), 17 (15.9 %) selective intrauterine growth restriction (sFGR), 12 (11.2 %) twin reversed arterial perfusion sequence (TRAPS), 25 (23.4 %) fetal discordant anomalies, 10 (9.3 %) elective fetal reduction (EFR), and three (2.8 %) twin anemia polycythemia sequence (TAPS) cases. The overall live birth rate for cotwins was 83.2 %. The earliest gestational age at delivery was noted in the TTTS group (p=0.021). The procedure-to-delivery interval was the shortest in the TTTS group and the longest in the EFR group (p<0.001). Comparing the 2013-2018 period with the 2019-2023 period, we noted a significant increase in the live birth rate (p=0.01) and the procedure-to-delivery interval (p=0.003), mainly due to improved outcomes in TTTS cases.</p><p><strong>Conclusions: </strong>RFA for SR is a safe and effective method for managing complicated MC pregnancies. The type of indication affects postoperative perinatal outcomes, with TTTS showing the most adverse effects. With the increasing number of cases and accumulation of experiences with simultaneous enhancement of technique proficiency, the postprocedural outcomes can be further improved.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"158-169"},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental growth factor as a predictive marker of preeclampsia in twin pregnancy.","authors":"Guijie Qi, Ling Yao, Zhiming Liu, Wanru Guo, Heng Liu, Jinghua Zhang, Yulian He, Tiancong Jiang","doi":"10.1515/jpm-2024-0184","DOIUrl":"10.1515/jpm-2024-0184","url":null,"abstract":"<p><strong>Objectives: </strong>Placental growth factor (PlGF) has been reported as a good biomaker for the prediction of preeclampsia occurring in the short term in singleton pregnancies, in women presenting with clinical suspicion of preeclampsia. This study aims to evaluate the predictive value of the PlGF in twin pregnancies.</p><p><strong>Methods: </strong>Twin pregnancies with clinically suspected preeclampsia (24 weeks 0 days-36 weeks 6 days of gestation) were enrolled in this study. The threshold of PlGF for predicting preeclampsia was determined on the basis of a receiver-operating characteristic curve to predict preeclampsia and the short-term occurrence of preeclampsia.</p><p><strong>Results: </strong>Within 1 week, 2 weeks, and 4 weeks of testing respectively, a cutoff value of 215 pg/mL for PlGF to predict preeclamsia in twin pregnancies suspected to have preeclampsia has a specificity of 100 %[51.7 %, 100 %], 100 %[62.9 %, 100 %], 93.8 %[667.6 %, 99.7 %], and a negative predictive value of 100 %[94.8 %, 100 %], 100 %[95.0 %, 100 %], and 98.9 %[93.0 %, 99.9 %].</p><p><strong>Conclusions: </strong>A cutoff value of 215 pg/mL for PlGF is a useful tool to exclude the development of preeclampsia within 4 weeks of measurement.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"149-157"},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of screening for large-for-gestational-age fetuses on maternal and neonatal outcomes: a prospective observational study.","authors":"Benjamin Birene, Alexandre Ferreira, Emilie Raimond, Olivier Graesslin, Uzma Ishaque, René Gabriel","doi":"10.1515/jpm-2024-0522","DOIUrl":"https://doi.org/10.1515/jpm-2024-0522","url":null,"abstract":"<p><strong>Objectives: </strong>Debates on the management of macrosomia are still current. We have to consider the consequences of screening to contribute to these discussions. Our aim is to study the consequences of the 3rd trimester fetal macrosomia screening protocols used in several centres in the same French region in order to determine whether this screening affects maternal and neonatal outcomes: mode of delivery, maternal complications (haemorrhage, perineal lesions), neonatal health (pH, Apgar score) and the occurrence of neonatal trauma during delivery.</p><p><strong>Methods: </strong>Prospective observational, multicenter cohort study (Reims, Châlons en Champagne and Charleville-Mézières hospitals). All women with low-risk pregnancies who could benefit from screening for fetal macrosomia were included. Neonatal macrosomia was defined as a weight above the 90th percentile according to AUDIPOG adjusted growth curves. The principal outcome was the cesarean section rate. Secondary outcomes were instrumental deliveries and maternal and neonatal morbidity and mortality.</p><p><strong>Results: </strong>2,217 women were included. Rates of cesarean section and instrumental delivery were higher if macrosomia had been screened, whether rightly, in large-for-gestational-age newborns (respectively 9,802 [1.638-190.290], p=0.038 and 3,021 [1.099-8.846], p=0.036) or wrongly, in newborns who were ultimately appropriate-for-date (respectively ORa 3.562 [1.377-10.128], p=0.01 and 3.042 [1.139-8.596], p=0.36). This screening did not reduce maternal and neonatal morbidity and mortality.</p><p><strong>Conclusions: </strong>Screening for fetal macrosomia may be associated with increased rates of cesarean section and instrumental delivery for large-for-gestational-age and appropriate-for-date newborns. These results do not show any impact of these variations on maternal or neonatal health, and do not allow us to change practices directly. They do, however, alert us to the consequences of widespread screening for LGA and its possible side effects, which could be better targeted to high-risk populations or improved according to other criteria.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant right subclavian artery: the importance of distinguishing between isolated and non-isolated cases in prenatal diagnosis and clinical management.","authors":"Claudia Montero Carreras, Berta Cortés Olivera, Raquel Saiz-Vivó, Queralt Ferrer Menduiña, Sandra Garcia Martínez, M A Rodríguez Pérez, Alberto Rodríguez Melcón, Pilar Prats Rodriguez","doi":"10.1515/jpm-2024-0398","DOIUrl":"https://doi.org/10.1515/jpm-2024-0398","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the association of aberrant right subclavian artery (ARSA) with genetic abnormalities and postnatal symptomatology, by comparing isolated and non-isolated ARSA cases.</p><p><strong>Methods: </strong>Retrospective, descriptive and comparative study involving fetuses diagnosed with ARSA during routine fetal ultrasound scans, between 19 and 40 weeks, in a tertiary referral university hospital in Barcelona from January 2007 to December 2023.</p><p><strong>Results: </strong>Out of 154 fetuses diagnosed with ARSA, 75.3 % (116) were classified as isolated cases, while 24.7 % (38) had associated structural anomalies. Non-invasive prenatal testing with cell-free DNA was performed in 27.3 % (42) of cases, yielding low-risk results in 96.6 %, with only one case of trisomy 21 detected. Genetic evaluation was pursued in 15.6 % (24) of cases, revealing abnormalities in three fetuses: one with trisomy 21 and two with 22q11 deletion. All affected fetuses had associated structural defects. Overall, 151 fetuses survived after birth, there were two terminations of pregnancy and one stillbirth. Mild symptoms at birth were observed in 1.9 % (3) of newborns, all from the non-isolated ARSA group.</p><p><strong>Conclusions: </strong>These findings emphasize the significance of distinguishing between isolated and non-isolated ARSA cases in prenatal diagnosis and clinical management, suggesting that isolated ARSA may be considered a normal vascular variation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the safety and diagnostic utility of amniocentesis after 24 weeks of gestation: a retrospective analysis.","authors":"Tanisha Gupta, Vatsla Dadhwal, Anubhuti Rana, Madhulika Kabra, Neerja Gupta, Rashmi Shukla, K Aparna Sharma","doi":"10.1515/jpm-2024-0434","DOIUrl":"https://doi.org/10.1515/jpm-2024-0434","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to describe the indications, complications, yield, and safety of amniocentesis beyond 24 weeks for prenatal diagnostic procedures along with the associated maternal and fetal outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 60 pregnant women (with 61 fetuses) who underwent amniocentesis at or beyond 24 weeks from March 2021 to June 2023 at a tertiary care referral center. Data was collected from medical records and individual patient followups. Descriptive data was collected on patient demographics, amniocentesis indications, and the test results. The other outcomes analyzed were the procedure-related complications and pregnancy outcomes.</p><p><strong>Results: </strong>The mean gestational age at time of the procedure was 25^4/7 (24^1/7-33^1/7). The most common indication for late amniocentesis was abnormal sonographic findings (44/61, 72.13 %), with structural anomalies being the commonest (21/61, 34.44 %). There were no complications related to the procedure. Of the 60 women, 88.3 % (53/60) continued their pregnancies, while 11.66 % (7/60) opted for termination of pregnancy, and two patients had intrauterine fetal demise (2/61, 3.27 %). Genetic testing revealed abnormalities in 6.55 % (4/61) of cases. Of the 51 pregnancies, 39 delivered vaginally (76.47 %; 39/51) and 12 (23.52 %; 12/51) required caesarean sections. There were five neonatal and infant deaths due to heart defects (2), metabolic syndrome, congenital diaphragmatic hernia, and non-immune hydrops, respectively.</p><p><strong>Conclusions: </strong>Amniocentesis, done at a later gestation, is a safe and an effective tool for prenatal diagnosis and provides an opportunity to make a genetic diagnosis and further counseling.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the pregnancy and labour course in women who underwent COVID-19 during pregnancy.","authors":"Elvira Shukenova, Meile Minkauskiene, Nurzhamal Dzhardemalieva, Lyailya Koshenova, Saule Ospanova","doi":"10.1515/jpm-2024-0302","DOIUrl":"10.1515/jpm-2024-0302","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyze the impact of COVID-19 on pregnancy and labor, focusing on its effects on maternal and child health. The research explores the relationships between coronavirus infection and clinical and laboratory parameters, as well as the risks of pregnancy complications and adverse birth outcomes.</p><p><strong>Methods: </strong>The study involved 60 pregnant women diagnosed with COVID-19. A comprehensive evaluation of clinical and laboratory indicators was conducted, employing correlation, regression, logistic analyses to determine risk factors.</p><p><strong>Results: </strong>There was a strong inverse correlation between carbon dioxide levels and haematocrit (-0.76), and a direct correlation between blood pH and partial pressure of oxygen (0.73). COVID-19 was associated with increased risks of preterm labor (OR=1.82), stillbirth (OR=2.11), pre-eclampsia (OR=1.46), and foetal distress. Multivariate analysis revealed a 200 g reduction in neonatal birth weight and higher risks of hospitalisation (OR=1.8), postpartum hemorrhage (OR=2.3), and preterm delivery (OR=2.5). Comorbid conditions such as cardiovascular abnormalities, diabetes, obesity, thrombophilias exacerbated the risks of complications, including pre-eclampsia, neonatal respiratory distress syndrome, venous thromboembolism.</p><p><strong>Conclusions: </strong>COVID-19 infection increases the likelihood of pregnancy complications and adverse outcomes, especially in women with comorbidities. These findings highlight the need for preventive strategies and risk management protocols for pregnant women during future outbreaks, emphasizing the importance of further research in this field.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"205-212"},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of the cerebro-placental ratio at term for predicting adverse perinatal outcomes in appropriate for gestational age fetuses.","authors":"Hannah Josten, Yvonne Heimann, Thomas Lehmann, Ekkehard Schleußner, Tanja Groten, Friederike Weschenfelder","doi":"10.1515/jpm-2024-0427","DOIUrl":"10.1515/jpm-2024-0427","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the relationship between the cerebro-placental ratio (CPR) measured at 40+0 weeks' gestation and perinatal outcomes to determine a CPR cut-off that may justify induction of labor at term in appropriately grown fetuses (AGA). Although CPR is used for monitoring growth-restricted fetuses, its role in guiding labor induction decisions for AGA pregnancies at term remains unclear.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from 491 singleton pregnancies with intended vaginal deliveries between 2015 and 2021. CPR was assessed at the actual estimated date of delivery (40+0 weeks' gestation). Adverse pregnancy outcome (APO) as the primary endpoint was defined by admission to neonatal intensive care unit (NICU), umbilical cord blood pH<7.1, 5-min APGAR<7 or interventions-due-to-fetal-distress during labor (IDFD=vaginal-operative delivery or emergency caesarean section).</p><p><strong>Results: </strong>APO nearly doubled (adjOR 1.7; CI 1.007-2.905) when CPR was below our calculated cut-off of 1.269 (18.4 vs. 32.3 %, p=0.002) and NICU admissions (4.8 vs. 11.1 %, p=0.020) and IDFD (12.5 vs. 21.2 %, p=0.027) significantly increased. The positive predictive value for the presence of APO using our cut-off was 32.4 %, and the negative predictive value 81.6 %.</p><p><strong>Conclusions: </strong>Our data confirm a predictive value of a reduced CPR at term with impaired perinatal outcome. The cut-off of CPR<1.269 may guide decision-making regarding induction of labor. Further prospective studies are needed to confirm these findings.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"188-195"},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}