Association between intrapartum fetal pulse oximetry and adverse perinatal and long‐term outcomes: A systematic review and meta‐analysis
Bibliographic record
Abstract
Abstract Background Fetal pulse oximetry may improve intrapartum fetal evaluation by providing a non‐invasive measurement of fetal oxygen saturation (FSpo2). Objectives To assess the association between abnormal intrapartum FSpo2 and perinatal and long‐term neurodevelopmental outcomes, and to evaluate if the addition of the measurement of FSpo2 to established forms of fetal monitoring, such as fetal heart rate monitoring, affects birth, perinatal, and long‐term neurodevelopmental outcomes. Search Strategy We conducted a comprehensive search of PubMed, EMBASE, CINAHL, The Cochrane Library, Web of Science, ClinicalTrials.gov , and WHO ICTRP from database inception through February 2024, with no restrictions on date, geographic region, country income level, or language. Selection Criteria Studies involving women in labor with a cephalic baby were included. Two interventions were reviewed: (1) low FSpo2 (<30%), and (2) the use of fetal pulse oximetry during labor. Data Collection and Analysis Independent reviewers screened studies, extracted data, and assessed quality using the Risk of Bias tool and the Newcastle‐Ottawa Scale. The approach evaluated evidence certainty. A random‐effects meta‐analysis followed PRISMA and MOOSE guidelines. Main Results Forty‐seven studies with 13 071 mother‐infant pairs were included. FSpo2 <30% was associated with umbilical artery pH <7.15 (odds ratio [OR] 7.86, 95% confidence interval [CI] 3.29–18.75, I2 = 71%, P < 0.001), 5‐min Apgar score less than 7 (OR 16.63, 95% CI 5.64–49.01, I2 = 30%, P < 0.001) and NICU admission (OR 5.89, 95% CI 1.73–20.01, I2 = 0%, P < 0.005). FSpo2 monitoring combined with fetal heart rate monitoring was associated with lower odds of cesarean section for non‐reassuring fetal status (OR 0.59, 95% CI 0.40–0.86, I2 = 71%, P = 0.006) without impacting 5‐min Apgar scores <7 (OR 0.66, 95% CI 0.37–1.17, I2 = 0%, P = 0.160) or neonatal intensive care unit admissions (OR 0.98, 95% CI 0.82–1.18, I2 = 0%, P = 0.840). Conclusion FSpo2 monitoring combined with fetal heart rate monitoring may reduce unnecessary cesarean sections for suspected fetal distress without affecting short‐term neonatal outcomes. The association between FSpo2 <30% and adverse perinatal outcomes supports its potential as a valuable adjunct in intrapartum monitoring.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.036 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.032 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".