Abstract
Background Increased uterine activity (UA) may not allow adequate
recovery time for foetal oxygenation. Objectives To determine if
increased UA during labour is associated with an increased risk of
either short- or long-term neurological injury in term neonates, or with
neonatal proxy measures of intrapartum hypoxia-ischemia. Search Strategy
MEDLINE, CINAHL, and ClinicalTrials.gov using terms uterine activity,
Excessive Uterine Activity, XSUA, Uterine hyperstimulation, and
Tachysystole. Selection Criteria Any study that analysed the
relationship between UA during term labour and neurological outcomes/
selected proxy neurological outcomes was eligible for inclusion. Data
Collection and Analysis Outcomes from individual studies were reported
in tables and presented descriptively with odds ratios (OR) and 95%
confidence intervals (CI) for dichotomous outcomes and means with
standard deviations for continuous outcomes. Where group numbers were
provided, ORs and CIs were calculated according to Altman. Main Results
Twelve studies met the inclusion criteria. Seven studies featured
umbilical artery pH as an individual outcome. Umbilical artery base
excess and Apgar scores were both reported as individual outcomes in
four studies. No study examined long term neurodevelopmental outcomes
and only one study reported on encephalopathy as an outcome. The
evidence for a relationship between UA and adverse infant outcomes was
inconsistent. The reported estimated effect size varied from
non-existent to clinically significant. Conclusions There is some
evidence that increased UA may be a non-specific predictor of depressed
neurological function in the newborn, but it is inconsistent and
insufficient to support the conclusion that an association generally
exists.