Severe Umbilical Cord Acidemia and Neurological Outcome in Preterm and Full-Term NeonatesLavrijsen S.W.a · Uiterwaal C.S.P.M.b · Stigter R.H.a · de Vries L.S.a · Visser G.H.A.a · Groenendaal F.a
aDivision of Perinatology and Gynecology, Wilhelmina Children’s Hospital, and bJulius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Background: Severe intrauterine hypoxia-ischemia and acidemia may lead to a disturbed neurodevelopment. Objectives: To study the effects of acidemia at birth on neurodevelopment in preterm and full-term neonates. Subjects and Methods: Short- and long-term outcome were studied retrospectively in 44 inborn preterms and 95 full-terms with severe acidemia at birth defined as a pH of the umbilical artery <7.00. Outcome was compared with 67 preterm and 90 full-term non-acidemic neonates (pH > 7.15). Intraventricular hemorrhage (preterms) or seizures (both preterms and full-terms) were considered an adverse short-term outcome. Neonatal death, cerebral palsy or neurodevelopmental delay were considered an adverse long-term outcome. Results: Severe intraventricular hemorrhage (IVH) occurred in 5 of the 44 (11%) acidemic preterms and in none of the 67 (0%) non-acidemic preterms (p < 0.01). Seizures were observed in 9 of the 44 (20%) and 11 of the 95 (12%) acidemic preterms and full-terms, respectively, and in none of the 67 (0%) and 1 of the 90 (1%) non-acidemic preterms and full-terms, respectively (p < 0.001 for preterms, p < 0.01 for full-terms). Nine preterms (6 acidemic, 3 non-acidemic) and 2 full-terms (both acidemic) died in the neonatal period. Adverse long-term outcome occurred in 32% of the acidemic preterms, in 21% of the non-acidemic preterms, in 7% of the acidemic full-terms and in 7% of the non-acidemic full-terms. Conclusions: Acidemia at birth increased the occurrence of severe IVH in preterm neonates and seizures in both preterm and full-term neonates. However, no significant effect of acidemia on long-term outcome could be demonstrated.
© 2005 S. Karger AG, Basel
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