Interobserver and intraobserver reliability of the NICHD 3-Tier Fetal Heart Rate Interpretation System

Sean C. Blackwell*, William A. Grobman, Leah Antoniewicz, Maria Hutchinson, Cynthia Gyamfi Bannerman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

OBJECTIVE: Our purpose was to test the reliability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 3-Tier Fetal Heart Rate (FHR) classification system. STUDY DESIGN: Individual 15- to 20-minute FHR segments (n=154) were independently reviewed without clinical data by 3 maternal-fetal medicine examiners and classified by NICHD category (I, II, III). RESULTS: Interobserver reliability was moderate (kappa 0.45) and varied by NICHD category (category I moderate [kappa 0.48], category II moderate [kappa 0.44], and category III poor [kappa 0.0]). The intraobserver agreement ranged from substantial to perfect (kappa 0.74-1.0). CONCLUSION: Interobserver agreement of 3-Tier FHR classification System was moderate for NICHD categories I and II. Agreement for category III tracings was poor mainly due to lack of agreement regarding absent vs minimal variability.

Original languageEnglish (US)
Pages (from-to)378.e1-378.e5
JournalAmerican journal of obstetrics and gynecology
Volume205
Issue number4
DOIs
StatePublished - Oct 2011

Keywords

  • Electronic fetal monitoring
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development classification system
  • Fetal heart rate
  • Fetal heart rate interpretation
  • Reliability

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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