Evolution of the Fetal Heart Rate Patterns in Cerebral Palsy Associated With Umbilical Cord Troubles: A Nationwide Study

Background: The aim of the present study was to clarify the evolution of the fetal heart rate (FHR) patterns in infants with cerebral palsy (CP) according to each type of umbilical cord trouble. Methods A case-control study was attempted in the subjects born from 2009 to 2014 and those with a birth weight of > 2000 g, gestational age of > 33 weeks, and disability due to CP, CP associated with (126 cases) and without (594 controls) umbilical cord troubles were compared. Results Therty-two were umbilical cord prolapse and 94 were other umbilical cord troubles coexisting antenatally. Abnormal FHR patterns had already been identified on admission in 13% of cases with umbilical cord prolapse and 40% of cases with cord trouble coexisting antenatally. A persistent non-reassuring pattern was significantly frequent in cases with cord trouble coexisting antenatally (p = 0.012) and less frequent in cases with umbilical cord prolapse (p = 0.003). Reactive-PD was significantly identified in 69% of the cases with umbilical cord prolapse and 35% of the cases with cord trouble coexisting antenatally, especially in the first stage of labor (p < 0.001). Conclusion Persistent non-reassuring patterns on admission and reactive-PD pattern during the 1st stage of labor were characterized in infants with CP related to umbilical cord troubles coexisting antenatally.