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Although electronic fetal monitoring (EFM) is routinely used in U.S. hospital births, its role in reducing neonatal mortality and morbidity while raising risk for unnecessary cesarean deliveries remains controversial. Investigators used U.S. birth certificate data from 1990 through 2004 linked to infant deaths within the first year to explore trends in EFM use and relevant outcomes in singleton live births between 24 and 44 weeks' gestation.
In nearly 58 million live births during the study period, use of EFM increased by 13% (from 73% in 1990 to 86% in 2004). When adjusted for EFM usage and several potential confounders, neonatal mortality declined during this period in all gestational age groups, ranging from a 5% decrease at 24 to 33 week…