Could Admission Non-stress Test Predict Neonatal Outcomes in Cesarean Deliveries? An Observational Study

Objectives: Despite the certainty of evidence regarding the predicting value of admission non-stress test (NST) in high-risk pregnancies at labor onset, data regarding low-risk pregnancies is conflicting. Additionally, most studies have mainly reported fetal heart rate (FHR) interpretation and categorization in laboring mothers and not in mothers experiencing false labor or even no uterine contractions. So, we aimed to assess the association between admission cardiotocography (aCTG) findings and neonatal outcomes in scheduled cesarean deliveries, who are a main subgroup of these patients. Materials and Methods: In this prospective observational study, 376 subjects were investigated in a tertiary center in Tehran, Iran from May 2020 to October 2021. All participants underwent a 20-minute aCTG and two blinded independent perinatologists interpreted each trace. Neonatal outcomes, including birth weight, Apgar scores, cord blood gas status, and neonatal admission were also recorded. Results: The mean number of late deceleration was 0.5 in neonates not admitted to the neonatal ward and 1 in neonates admitted to the neonatal ward, and the difference was statistically significant (P=0.001). Numbers of Lambda decelerations were statistically correlated with cord blood pH (correlation coefficient=-0.119; P=0.022). No other significant association was found between CTG characteristics and cord blood gas status, low birth weight, and/or Apgar scores. Although adverse outcomes were uncommon, associations between these outcomes and CTG findings were not significant. Conclusions: Performing an aCTG does not seem cost-beneficial in predicting perinatal outcomes in scheduled term cesarean deliveries.