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

TL;DR

This study aims to evaluate if fetal pulse oximetry during labor improves detection of risks to babies compared to current methods.

Contribution

A systematic review and meta-analysis protocol to assess fetal pulse oximetry's effectiveness in predicting adverse outcomes.

Findings

Current fetal monitoring methods increase operative deliveries but fail to prevent hypoxic brain injury.

Fetal pulse oximetry may offer a non-invasive way to assess fetal oxygenation during labor.

The study will synthesize evidence from multiple trial types to evaluate FPO's effectiveness.

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 and Web of Science will be conducted following a detailed search strategy until August 2023. Three authors will independently review titles, abstracts and full text of articles. Two reviewers will independently extract data using pre-defined data extraction and assess the quality using the Risk of Bias tool for RCTs and Newcastle-Ottawa Scale for observational studies. 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 guidelines.

PROSPERO registration: CRD42023457368 (04/09/2023)