Umbilical cord pH and base excess values in relation to neonatal morbidity for infants delivered preterm. 2003

Rahi Victory, and Deborah Penava, and Orlando da Silva, and Renato Natale, and Bryan Richardson
Department of Obstetrics and Gynecology, Pediatrics, and Physiology, St Joeseph's Health Care, University of Western Ontario, Canada.

OBJECTIVE Our purpose was to determine the relationship/predictive value of umbilical cord pH and base excess (BE) values to adverse neonatal outcomes for preterm infants. METHODS A tertiary center perinatal/neonatal database was used to obtain umbilical cord pH and BE values, adverse neonatal outcomes, and patient demographics for preterm (PT, 32-36 weeks gestational age) and very preterm (VPT, 25-32 weeks gestational age) singleton live-born infants delivered between November 1995 and March 2002. RESULTS PT (n=1807) and VPT (n=603) groups demonstrated a significant inverse curvilinear relationship of umbilical cord pH and BE values to Apgar score <7 at 5 minutes, respiratory distress syndrome, assisted ventilation, and intraventricular hemorrhage/periventricular leukomalacia. Receiver operating characteristic area under the curve values ranged from 0.69 to 0.86 (PT) and 0.70 to 0.87 (VPT). There was little difference between umbilical vein, umbilical artery, pH, or BE in predictive value. CONCLUSIONS Umbilical cord pH and BE are related to subsequent adverse outcome events for infants delivered preterm. Worsening acidosis is associated with progressively greater increases in these outcomes with no discriminatory value within or between umbilical artery and umbilical vein pH and BE.

UI MeSH Term Description Entries
D007226 Infant Mortality Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth. Neonatal Mortality,Mortality, Infant,Postneonatal Mortality,Infant Mortalities,Mortalities, Infant,Mortalities, Neonatal,Mortalities, Postneonatal,Mortality, Neonatal,Mortality, Postneonatal,Neonatal Mortalities,Postneonatal Mortalities
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234 Infant, Premature A human infant born before 37 weeks of GESTATION. Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D007969 Leukomalacia, Periventricular Degeneration of white matter adjacent to the CEREBRAL VENTRICLES following cerebral hypoxia or BRAIN ISCHEMIA in neonates. The condition primarily affects white matter in the perfusion zone between superficial and deep branches of the MIDDLE CEREBRAL ARTERY. Clinical manifestations include VISION DISORDERS; CEREBRAL PALSY; PARAPLEGIA; SEIZURES; and cognitive disorders. (From Adams et al., Principles of Neurology, 6th ed, p1021; Joynt, Clinical Neurology, 1997, Ch4, pp30-1) Cystic Periventricular Leukomalacia,Encephalomalacia, Periventricular,Neonatal Cerebral Leukomalacia,Periventricular Leukomalacia,Leucomalacia, Periventricular,Cerebral Leukomalacia, Neonatal,Cerebral Leukomalacias, Neonatal,Cystic Periventricular Leukomalacias,Encephalomalacias, Periventricular,Leucomalacias, Periventricular,Leukomalacia, Cystic Periventricular,Leukomalacia, Neonatal Cerebral,Leukomalacias, Cystic Periventricular,Leukomalacias, Neonatal Cerebral,Leukomalacias, Periventricular,Neonatal Cerebral Leukomalacias,Periventricular Encephalomalacia,Periventricular Encephalomalacias,Periventricular Leucomalacia,Periventricular Leucomalacias,Periventricular Leukomalacia, Cystic,Periventricular Leukomalacias,Periventricular Leukomalacias, Cystic
D009017 Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Morbidities
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012127 Respiratory Distress Syndrome, Newborn A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause. Infantile Respiratory Distress Syndrome,Neonatal Respiratory Distress Syndrome,Respiratory Distress Syndrome, Infant
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D005312 Fetal Blood Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery. Cord Blood,Umbilical Cord Blood,Blood, Cord,Blood, Fetal,Blood, Umbilical Cord,Bloods, Cord,Bloods, Fetal,Bloods, Umbilical Cord,Cord Blood, Umbilical,Cord Bloods,Cord Bloods, Umbilical,Fetal Bloods,Umbilical Cord Bloods
D005317 Fetal Growth Retardation Failure of a FETUS to attain expected GROWTH. Growth Retardation, Intrauterine,Intrauterine Growth Retardation,Fetal Growth Restriction,Intrauterine Growth Restriction

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