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Outcomes of extremely low birthweight infants with acidosis at birth

David A Randolph1, Tracy L Nolen2, Namasivayam Ambalavanan3

  • 1Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA Department of Pediatrics, Rocky Mountain Hospital for Children, Denver, Colorado, USA.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 21, 2014
PubMed

Insights

Acidosis at birth is linked to death or neurodevelopmental impairment in extremely low birthweight infants. However, other factors are more critical for predicting these outcomes in this vulnerable population.

Area of Science:

  • Neonatal Research
  • Perinatal Medicine
  • Pediatric Neurology

Background:

  • Extremely low birthweight (ELBW) infants face significant risks of mortality and neurodevelopmental impairment (NDI).
  • Perinatal acidosis, a condition of excessive acidity at birth, is a potential contributor to adverse outcomes in neonates.

Purpose of the Study:

  • To investigate the association between perinatal acidosis and the combined outcome of death or NDI in ELBW infants.
  • To develop a predictive model for death/NDI, assessing the role of perinatal acidosis.

Main Methods:

  • Analysis of cord blood gas data from ELBW infants born between 2002-2007.
  • Inclusion criteria: documented mortality or 18-22 month neurodevelopmental assessment.
  • Logistic regression used to evaluate acidosis (pH<7 or base excess<-12) and develop a predictive model.

Main Results:

  • Perinatal acidosis (pH<7 or BE<-12) was significantly associated with increased risk of death/NDI (OR=2.5 and 1.5, respectively).
  • However, incorporating acidosis parameters did not enhance the predictive accuracy of the multivariable model.
  • The study identified 3979 infants, with 53% experiencing the primary outcome.

Conclusions:

  • Perinatal acidosis is a significant risk factor for death and NDI in ELBW infants.
  • Despite its significance, acidosis is infrequent in this population, and other factors hold greater predictive value.
Abstract

Keywords:
NeonatologyNeurodevelopment

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