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Acta Paediatr. 2019 Apr 7. doi: 10.1111/apa.14812. [Epub ahead of print]

Umbilical artery pH and base excess at birth are poor predictors of neurodevelopmental morbidity in early childhood.

Author information

1
Children's Hospital, Paediatric Research Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
2
National Institute for Health and Welfare, Information Services Department, Helsinki, Finland.
3
Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Stockholm, Sweden.
4
Department of Obstetrics and Gynaecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Abstract

AIM:

We sought to evaluate the associations between umbilical artery pH and base excess and neurodevelopmental outcome at four years of age.

METHODS:

This study comprised 84,588 singleton children born alive at term in 2005-2011 in the hospital district of Helsinki and Uusimaa in Finland. Data from the maternity hospital information system were linked to the data from the Medical Birth Register and the Hospital Discharge Register. Neurodevelopmental morbidity included cerebral palsy, epilepsy, intellectual or sensorineural impairment.

RESULTS:

After adjustment for maternal and perinatal factors, a combination of pH <7.00 and base excess <-16.00 was associated with infant death (adjusted odds ratio 19.97; 95% confidence interval 5.38-74.17). Values of pH 7.00-7.10 was associated with cerebral palsy (adjusted odds ratio 2.40; 95% confidence interval 1.05-5.47). A combination of low five-minute Apgar score and umbilical artery base excess <-16.00 showed the highest positive predictive value (9.1%) for neurodevelopmental impairments. When umbilical artery pH <7.00 was included, a positive predictive value of 25.0% was observed for infant mortality.

CONCLUSION:

Low umbilical artery pH and base excess at birth were poor predictors of long-term neurodevelopmental morbidity in an unselected population. However, these parameters might be useful in assessing the risk of infant mortality. This article is protected by copyright. All rights reserved.

KEYWORDS:

pH ; base excess; infant mortality; neurodevelopmental morbidity; umbilical artery blood gas

PMID:
30955219
DOI:
10.1111/apa.14812

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