Risk factors for intrapartum acidemia - a cohort study

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 31; no. 24; pp. 3232 - 3237
• Main Authors: Wretler, Stina, Nordström, Lennart, Graner, Sophie, Holzmann, Malin
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 17-12-2018
• Subjects: Acidosis, Lactic - blood; Acidosis, Lactic - epidemiology; Adolescent; Adult; Cohort Studies; Female; Fetal blood; Fetal Blood - chemistry; Fetal Diseases - blood; Fetal Diseases - epidemiology; fetal distress; fetal monitoring; Humans; lactate; language barriers and risk factors; Medicin och hälsovetenskap; Middle Aged; Pregnancy; Risk Factors; Scalp; Sweden - epidemiology; Young Adult; Sweden; Fetal blood; fetal distress; fetal monitoring; lactate; language barriers and risk factors
• ISSN: 1476-7058; 1476-4954; 1476-4954
• DOI: 10.1080/14767058.2017.1368074

Purpose: Birth acidemia is associated with short- and long-term morbidity in the child. Optimal intrapartum surveillance and timely interventions may reduce the incidence of these outcomes. Knowledge about conditions which increase the risks might be beneficial for optimal care. The aim with this study was to identify factors which increased the risk for lactacidemia in fetal scalp blood.
Materials and methods: A secondary analysis of a cohort study performed at Karolinska University Hospital Stockholm Sweden between February 2009 and February 2011. The study population included 1070 women in labor where fetal scalp blood sampling (FBS) was performed.
Results: In a univariate logistic regression analysis for lactate >4.8 mmol/L at FBS, minor language barriers (OR 2.54; 95%CI 1.26-5.11), active bearing down (OR 2.46; 95%CI 1.12-5.39) and maternal height <155 cm (OR 2.15; 95%CI 1.08-4.26) were found as risk factors. In a multivariate logistic regression analysis, minor language barriers (OR 2.21; 95%CI 1.05-4.67) and active pushing (OR 2.68; 95%CI 1.20-6.00) remained significant.
Conclusions: Language barriers, active pushing and short stature were found to be significant risk factors for intrapartum lactacidemia. In the group with minor language problems better use of interpreters might be beneficial.