Valor predictivo del test no estresante para cesárea y su relación con indicadores tempranos de compromiso neurológico neonatal

Paola A. Díaz-Quispillo; Bertha A.  Landa-Maturrano; Isabel Lipa-Condori; Andrea Carmenes-Carrasco; Brandon E. Guillen Calle

doi:10.59594/iicqp.2026.v4n1.155

Authors

Paola A. Díaz-Quispillo Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru. https://orcid.org/0000-0002-4115-794X
Bertha A. Landa-Maturrano Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru. https://orcid.org/0000-0001-7842-8363
Isabel Lipa-Condori Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru.
Andrea Carmenes-Carrasco Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru. https://orcid.org/0009-0005-5121-1662
Brandon E. Guillen Calle Research and Technological Innovation Subunit, Instituto Nacional de Salud del Niño San Borja, Lima 15037, Peru. https://orcid.org/0009-0001-5161-266X

DOI:

https://doi.org/10.59594/iicqp.2026.v4n1.155

Keywords:

Apgar Score, Cesarean Section, Fetal Monitoring, Childbirth, Forecasting

Abstract

Objective: To evaluate the predictive capacity of the non-stress test (NST) to determine the mode of delivery by cesarean section and Apgar scores at 1 and 5 minutes.

Methods: Quantitative, analytical diagnostic validity, non-experimental, and cross-sectional study conducted using NST results from 944 pregnant women attended at the electronic fetal monitoring service of a public hospital in Lima, Peru, during 2023. Live-born neonates whose mothers had a conclusive NST were included, excluding cases with congenital malformations or interrupted tests. Mathematical formulas were applied to calculate diagnostic validity measures and predictive values.

Results: The median maternal age was 29.0 years (IQR: 24.0–34.0). A total of 71.0% of NST results were reactive and 29.0% were non-reactive. Cesarean delivery predominated (52.2%). The NST showed a sensitivity of 27.4%, specificity of 69.2%, positive predictive value (PPV) of 49.3%, and negative predictive value (NPV) of 46.6% for predicting cesarean delivery. For an Apgar score <7 at 1 minute, the sensitivity of the NST was 36.1%, specificity 71.3%, PPV 4.7%, and NPV 96.6%. At 5 minutes, the sensitivity of the NST decreased to 16.7%, specificity to 70.9%, PPV to 0.4%, and NPV to 99.3%.

Conclusions: The NST shows limited sensitivity and PPV for determining the mode of delivery and initial neonatal depression based on the Apgar score. However, its high NPV supports its usefulness as a screening tool to rule out acute fetal compromise, always in combination with clinical and obstetric criteria within a comprehensive fetal assessment approach.

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