Fetal heart rate and survival of the very premature newborn

Objective: Our purpose was to study the likelihood of survival of infants who are born before 28 weeks of gestation and to examine the influence of fetal heart rate findings on neonatal death. Study Design: In this retrospective study, we analyzed the mortality rate of infants at 2 months of age as a function of various obstetric and prenatal indicators. Results: At 2 months, 207 of 325 children were still alive. The survival rate was also a function of gestational age, birth weight, the administration of corticosteroids, multiple pregnancies, and fetal heart rate. Fetal heart rate had the greatest effect on the mortality rate. Children with a reactive rate were 4 times more likely to survive than children with a flat tracing (P = .003; odd ratio, 4; 95% CI, 12.1; 39.8). Conclusion: The results in our study lead us to think that recording the fetal heart rate before and during labor may be useful in the prediction of perinatal death and may help obstetric decision-making. (Am J Obstet Gynecol 2002;187:1026-30.)