Acta Obstet Gynecol Scand. 2025 Nov 29. doi: 10.1111/aogs.70110. Online ahead of print.
ABSTRACT
INTRODUCTION: At Kuopio University Hospital (KUH), the rate of fetal blood sampling (FBS) among women undergoing a trial of labor has markedly decreased over the past 20 years. The aim of this study was to evaluate the association of this decline with birth outcomes and how maternal and delivery characteristics have changed over the extended study period.
MATERIAL AND METHODS: This retrospective registry-based study included 40 309 singleton pregnancies with a live vertex-presenting fetus at or beyond 33 weeks of gestation with a trial of labor and deliveries between January 2002 and December 2021. Prenatal and birth data were obtained from the KUH birth registry, and variables were analyzed across four intervals of 5 years. The evaluated birth outcomes included the mode of delivery, labor induction, meconium-stained or bloody amniotic fluid, birthweight, 5-min Apgar scores, physician-diagnosed asphyxia, perinatal death, and admission to the neonatal intensive care unit (NICU).
RESULTS: During the 20-year study period, intrapartum FBS was performed in 3486 cases (8.6%), while 36 823 women (91.4%) delivered without FBS. The use of FBS declined from 11.7% to 3.9% (p < 0.001). Concurrently, the rate of spontaneous vaginal deliveries increased from 83.6% to 87.6%, whereas nonelective cesarean deliveries decreased from 8.4% to 4.3%. Fewer newborns were diagnosed with asphyxia by physicians and admitted to the NICU. However, the incidence of low 5-min Apgar scores (<7) peaked with a 77.8% increase during the last study period compared to the preceding one, coinciding with the lowest rate of FBS use. General trends included declines in birth rate, maternal smoking, and gestational age at birth, as well as increases in maternal age, body mass index, and the rate of labor induction.
CONCLUSIONS: The change in FBS rate may reflect evolving clinical assessment criteria and more stringent selection strategies for its use. However, it may also be associated with an increased number of cases presenting with low Apgar scores.
PMID:41316915 | DOI:10.1111/aogs.70110
