Is there an association between fetal scalp electrode application and early-onset neonatal sepsis in term and late preterm pregnancies? A case-control study.

OBJECTIVE

Early-onset neonatal sepsis (EONS), defined as neonatal sepsis occurring within the first week after birth, is a major cause of morbidity and mortality. Fetal scalp electrode application, used for fetal heart rate monitoring during labour, could potentially increase the risk of EONS. The objective of this study was to determine whether this practice is associated with a significant risk for EONS in term and late preterm pregnancies.

METHODS

This case-control study enrolled subjects from three maternity hospitals in Edmonton. Cases were neonates with EONS who were born at ≥ 34 weeks between January 1, 2000, and March 1, 2011. Two control subjects were enrolled for each case identified. Control subjects were neonates of similar gestation (≥ 34 weeks), born at the same hospital site, who did not develop EONS. Maternal charts were accessed for information about fetal scalp electrode application and potential confounding variables.

RESULTS

Forty cases and 80 control subjects were identified. There was no difference in the rate of exposure to fetal scalp electrode in cases (6/40) and control subjects (10/80) (OR 1.24; 95% CI 0.42 to 3.68, P = 0.92). The association between fetal scalp electrode application and EONS remained non-significant despite adjustment for confounders.

CONCLUSION

We did not detect an association between the use of fetal scalp electrode and EONS, but our study was powered to detect only a strong association between the exposure of interest and the disease outcome. We cannot rule out a weakly positive association that may still exist.