Association between intrapartum fetal pulse oximetry and adverse perinatal and long-term outcomes: a systematic review and meta-analysis protocol

Jill M Mitchell; Siobhan Walsh; Laura J O'Byrne; Virginia Conrick; Ray Burke; Ali S Khashan; John Higgins; Richard Greene; Gillian M Maher; Fergus P McCarthy

doi:10.12688/hrbopenres.13802.2

Association between intrapartum fetal pulse oximetry and adverse perinatal and long-term outcomes: a systematic review and meta-analysis protocol

HRB Open Res. 2024 Mar 28:6:63. doi: 10.12688/hrbopenres.13802.2. eCollection 2023.

Authors

Jill M Mitchell^{1

2}, Siobhan Walsh², Laura J O'Byrne^{1

2}, Virginia Conrick³, Ray Burke⁴, Ali S Khashan^{1

5}, John Higgins², Richard Greene^{2

6}, Gillian M Maher^{1

5}, Fergus P McCarthy^{1

2}

Affiliations

¹ INFANT Research Centre, University College Cork, Cork, County Cork, Ireland.
² Department of Obstetrics and Gynaecology, University College Cork, Cork, County Cork, Ireland.
³ UCC Library, University College Cork, Cork, County Cork, Ireland.
⁴ Tyndall National Institute, University College Cork, Cork, County Cork, Ireland.
⁵ School of Public Health, University College Cork, Cork, County Cork, Ireland.
⁶ National Perinatal Epidemiology Centre, University College Cork, Cork, County Cork, Ireland.

Abstract

Background: Current methods of intrapartum fetal monitoring based on heart rate, increase the rates of operative delivery but do not prevent or accurately detect fetal hypoxic brain injury. There is a need for more accurate methods of intrapartum fetal surveillance that will decrease the incidence of adverse perinatal and long-term neurodevelopmental outcomes while maintaining the lowest possible rate of obstetric intervention. Fetal pulse oximetry (FPO) is a technology that may contribute to improved intrapartum fetal wellbeing evaluation by providing a non-invasive measurement of fetal oxygenation status.

Objective: This systematic review and meta-analysis aims to synthesise the evidence examining the association between intrapartum fetal oxygen saturation levels and adverse perinatal and long-term outcomes in the offspring.

Methods: We will include randomised control trials (RCTs), cohort, cross-sectional and case-control studies which examine the use of FPO during labour as a means of measuring intrapartum fetal oxygen saturation and assess its effectiveness at detecting adverse perinatal and long-term outcomes compared to existing intrapartum surveillance methods. A detailed systematic search of PubMed, EMBASE, CINAHL, The Cochrane Library, Web of Science, ClinicalTrials.Gov and WHO ICTRP will be conducted following a detailed search strategy until February 2024. Three authors will independently review titles, abstracts and full text of articles. Two reviewers will independently extract data using a pre-defined data extraction form and assess the quality of included studies using the Risk of Bias tool for RCTs and Newcastle-Ottawa Scale for observational studies. The grading of recommendations, assessment, development, and evaluation (GRADE) approach will be used to evaluate the certainty of the evidence. We will use random-effects meta-analysis for each exposure-outcome association to calculate pooled estimates using the generic variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-analyses and MOOSE guidelines.

Prospero registration: CRD42023457368 (04/09/2023).

Keywords: Labour; Sp02; blood gas monitoring; fetal monitoring; intrapartum; oximetry; oxygen saturation.

Associated data

figshare/10.6084/m9.figshare.24049890.v3

Grants and funding

The author(s) declared that no grants were involved in supporting this work.