Investigation of the Relationship between the Non-Reassuring Pattern of CTG and Maternal Risk Factors at a Referral Hospital in Zambia

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K19684
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58070:Lifelong developmental nursing-related
• Research Institution: Nagasaki University (2020-2022); Wakayama Medical University (2019)
• Principal Investigator: Fujita Wakako 長崎大学, 医歯薬学総合研究科(保健学科), 准教授 (10732753)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 分娩監視装置 / 胎児心拍数モニタリング / ザンビア

Outline of Final Research Achievements

This study included secondary-level hospitals in Zambia where cesarean sections were available. Women admitted for delivery were recruited for fetal well-being monitoring using Cardiotocography (CTG). A total of 251 CTG data sets were collected. Out of these, 24 data sets were excluded due to unclear information, and the analysis was conducted on the remaining 227 CTG data sets. Levels 1 and 2 were categorized as normal waveforms while levels 3 and above were categorized as abnormal waveforms. The estimated probability of encountering abnormal waveforms was 25.6% (95% CI: 20.4%-31.7%). No significant association was found between maternal and fetal risk factors and abnormal waveforms. The odds ratio for the active phase of the labor was 3.84 (95%CI:1.52-9.70, p=0.005), which emerged as the sole factor influencing abnormal waveforms.

Free Research Field

助産学

Academic Significance and Societal Importance of the Research Achievements

分娩時に間歇的聴診法を行っているザンビアにおいて、分娩目的で入院した産婦にCTGを装着し、胎児の健康状態を調べた先行研究はない。入院時の産婦の異常波形は、25.6％（95%CI:20.4%-31.7%）と高い割合で認められた。母体や胎児のリスク要因に関わらず、活動期には異常波形が起こるリスクがあることを念頭に、間欠的聴診法の質を高める必要がある。また、間欠的聴診法で徐脈を発見した時には、CTGを装着し、胎児の健康状態を判定し、適切な対処を行うことが新生児のアウトカムをあげることにつながる。本研究の結果は、リスク要因の有無に関わらず、全産婦に対し胎児モニタリングの質を高める必要性を示している。