Neonatal organ dysfunction among newborns at gestational age 34 weeks and umbilical arterial pH < 7.00

Purpose. Among newborns at 34 weeks or more with umbilical arterial pH < 7.00, we endeavoured to determine the pH threshold and risk factors for neonatal organ injury within 72 hours of birth. Study design. Retrospectively, all non-anomalous newborns delivered over 6 years near term with a low pH...

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Published in:The journal of maternal-fetal & neonatal medicine 2005-04, Vol.17 (4), p.261-268
Main Authors: Chauhan, Suneet P, Hendrix, Nancy W, Magann, Everett F, Sanderson, Maureen, Bofill, James A, Briery, Christian M, Morrison, John C
Format: Article
Language:English
Subjects:
Acid-Base Imbalance - mortality
Acid-Base Imbalance - physiopathology
Adult
Brain Diseases - mortality
Brain Diseases - physiopathology
Cohort Studies
Female
Fetal Blood - chemistry
Gestational Age
Heart Diseases - mortality
Heart Diseases - physiopathology
Humans
Hydrogen-Ion Concentration
Infant Mortality
Infant, Newborn
Kidney Diseases - mortality
Kidney Diseases - physiopathology
Respiratory Distress Syndrome, Newborn - mortality
Respiratory Distress Syndrome, Newborn - physiopathology
Retrospective Studies
Umbilical Arteries
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Summary:Purpose. Among newborns at 34 weeks or more with umbilical arterial pH < 7.00, we endeavoured to determine the pH threshold and risk factors for neonatal organ injury within 72 hours of birth. Study design. Retrospectively, all non-anomalous newborns delivered over 6 years near term with a low pH were identified. Each case of a newborn with injury was compared with the next four neonates with a pH below 7.00 and no injury. A receiver-operating characteristic (ROC) curve and unconditional logistic regression was used. Results. Of the 87 newborns with pathologic acidosis, 16% had neonatal organ system injury. Inspection of the ROC curve indicates that a pH of 6.92 is the threshold that identifies newborns who will have damage to organs. Unconditional logistic regression analysis indicates that the significant risk factors for morbidity were an Apgar score 7 at 5 minutes, an UA pH 6.92, a sentinel event, and a history of maternal seizures among those at 37 weeks or more. Conclusions. Among newborns at 37 weeks, pH 6.92 is the threshold linked with neonatal organ dysfunction.
ISSN:1476-7058
1476-4954
DOI:10.1080/14767050500073134