Center for Urban Population Health, Milwaukee, WI, USA.
Am J Obstet Gynecol. 2011 Jun;204(6):491.e1-10. doi: 10.1016/j.ajog.2011.04.024. Epub 2011 Apr 20.
To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity.
We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders.
In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores <4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65).
In the United States, the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality.
探讨电子胎儿心率监测与新生儿和婴儿死亡率以及新生儿发病率的关系。
我们使用了美国 2004 年的出生和婴儿死亡关联数据。采用多变量对数二项式回归模型来估计电子胎儿心率监测与死亡率之间的关联风险比，同时调整了潜在的混杂因素。
2004 年，89%的单胎妊娠接受了电子胎儿心率监测。电子胎儿心率监测与婴儿死亡率显著降低相关（调整后的相对风险，0.75）；这主要是由于早期新生儿死亡率的风险降低（调整后的相对风险，0.50）所致。在低风险妊娠中，电子胎儿心率监测与 5 分钟时 Apgar 评分<4 的风险降低相关（相对风险，0.54）；在高风险妊娠中，与新生儿癫痫发作的风险降低相关（相对风险，0.65）。
在美国，电子胎儿心率监测的使用与早期新生儿死亡率和发病率的显著降低有关，从而降低了婴儿死亡率。
