Cerebral pathology in the pre-term infant and associated peripartum metabolic acidosis

In a prospective study of 217 infants who were delivered before 37 weeks' gestation and in whom serial cranial ultrasound scans were performed to identify cerebral pathology, multivariate analysis, including a wide range of peripartum and neonatal variables, demonstrated that metabolic acidosis present at delivery and persisting during the early neonatal period was associated with the development of cerebral pathology in these infants. These findings support the hypothesis that the condition at birth of the preterm infant as assessed by acid/base balance, which reflects events occurring during labour and delivery, is an important factor in the subsequent development of cerebral pathology. In addition, the data support the view that obstetric policies aimed at avoiding metabolic acidosis at birth are likely to be of benefit to the pre-term infant.