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Outcomes among term infants when two-hour postnatal pH is compared with pH at delivery
B M Casey1, K G Goldaber, D D McIntire
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032, USA.
American Journal of Obstetrics and Gynecology
|March 3, 2001
Summary
Persistent or developing acidemia in newborns significantly increases seizure risk. Acidemia at birth that improves within two hours is associated with the lowest risk of seizures in term infants.
Area of Science:
- Neonatal Medicine
- Perinatal Research
- Pediatric Neurology
Background:
- Neonatal acidemia is a critical condition affecting infant outcomes.
- Understanding the trajectory of acid-base balance in newborns is crucial for predicting morbidity.
Purpose of the Study:
- To compare infant outcomes based on pH levels at birth versus within two hours of age.
- To investigate the relationship between pH changes and neonatal complications.
Main Methods:
- Retrospective study of 1691 term infants with serial umbilical artery blood pH measurements.
- Comparison of pH at birth with pH measured within two hours post-birth.
- Statistical analysis using chi-squared tests and Mantel-Haenszel methods for odds ratios and confidence intervals.
Main Results:
- 11% of infants had persistent acidemia (pH <7.20) at birth and within 2 hours; 6% developed acidemia after birth.
- Persistent acidemia was strongly associated with seizures (OR 13.0), as was newly developed acidemia (OR 5.7).
- Infants with corrected acidemia had the lowest seizure risk (OR 2.5) compared to the reference group.
Conclusions:
- The direction of pH change from birth to the neonatal period is a significant predictor of morbidity.
- Maternal and neonatal health outcomes are closely linked to acid-base status in the immediate postnatal period.
- Early identification and management of acidemia are vital for improving neonatal outcomes.