01:08pm Saturday 19 October 2019

Severe asphyxia linked to substandard care during labour

Sophie Berglund Photo: Minna Berglund

In the study, which is published in the scientific journal BJOG, researchers from the Department of Clinical Science and Education sought to investigate the impact of substandard care during labour and delivery on infant outcome. The study is based on all births in Stockholm County, Sweden, between 2004 and 2006. The study population represents 24% (74 539) of all births in Sweden during this time. Risk factors and handling of 313 infants with signs of asphyxia at birth (at 5 minutes of age) were compared to 313 healthy control infants.

The researchers found that if there was substandard care during labour, the risk was three-fold that the infant would show signs of asphyxia at 5 minutes of age. The main reasons for substandard care were related to misinterpretation of CTG (recording of fetal heartbeat and uterine contractions during childbirth), not acting on an abnormal CTG in a timely fashion, and misuse of oxytocin.

While the data relates to deliveries in Sweden, the results emphasize the importance of reacting promptly to signs of asphyxia. The authors call for educational efforts among physicians and midwives to improve CTG interpretation and fetal surveillance.

“There was substandard care during labour in two thirds of infants born with signs of asphyxia, and in one third of healthy infants”, says lead author, Dr Sophie Berglund.

“The main reasons for substandard care are factors that, in theory, are possible to prevent, and in practice, should be possible to reduce through educational efforts and increased awareness of risk factors associated with risk of asphyxia.”


Berglund S, Pettersson H, Cnattingius S, Grunewald C.

How often is a low Apgar score the result of substandard care during labour?

BJOG; An International Journal of Obstetrics and Gynaecology, 21 April 2010, DOI: 10.1111/j.1471-0528.2010.0265.x.

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