Evidence mapPaperPMID 40312524Full record

ArticleNPJ digital medicine2025

Impact of missing electronic fetal monitoring signals on perinatal asphyxia: a multicohort analysis.

Debjyoti Karmakar, Lochana Mendis, Emerson Keenan, Marimuthu Palaniswami, Roxanne Hastie, Enes Makalic, Fiona Brownfoot

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Debjyoti KarmakarMercy Hospital for Women/University of Melbourne, Melbourne, VIC, Australia. debmelbourne@gmail.com.
Lochana MendisDepartment of Electrical Engineering, University of Melbourne, Melbourne, VIC, Australia.
Emerson KeenanMercy Hospital for Women/University of Melbourne, Melbourne, VIC, Australia.
Marimuthu PalaniswamiDepartment of Electrical Engineering, University of Melbourne, Melbourne, VIC, Australia.
Roxanne HastieMercy Hospital for Women/University of Melbourne, Melbourne, VIC, Australia.
Enes MakalicMonash University, Melbourne, VIC, Australia.
Fiona BrownfootMercy Hospital for Women/University of Melbourne, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cardiotocography (CTG) is essential for monitoring high-risk pregnancies, yet perinatal asphyxia prediction accuracy remains limited to 50-55%. Regions of artifacts (missing valid signals)-including signal processing aberrations-possibly contribute to this limitation, highlighted by 40% of FDA reports on intrapartum stillbirths. This cohort study applied causal inference to two digitized CTG databases, analyzing 36,792 labor episodes (>36 weeks) at a tertiary Australian hospital (2010-2021) and externally validating on a Czech dataset (n = 552).High rates of missing valid signals (>30% fetal heart rate signal dropout or >1% maternal-fetal heart rate coincidence) was independently associated with asphyxia (aOR 1.47, 95% CI 1.19-1.81); dropout >30% showing stronger link (aOR 1.58, 95% CI 1.13-2.20 Australian dataset; aOR 2.30, 95% CI 1.08-4.91 Czech dataset). Risk of asphyxia increased with higher dropout (>37.45%, aOR 2.21 Australian dataset; >34.01%, aOR 4.08 Czech dataset). Integrating measures of missing valid signals into fetal monitoring algorithms may improve decision-making and neonatal outcomes.

Identifiers

PMID40312524
PMCPMC12045961

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.