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Updated: Jun 14, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Clinical features and their associations with umbilical cord gas abnormalities
Allison Payne1, Gianna Wilkie2, Katherine Leung2
1Department of Obstetrics and Gynecology, UMass Memorial Medical Center, Worcester, MA, USA - allison.payne@umassmemorial.org.
Background:
We seek to identify risk factors associated with abnormal umbilical artery cord gas (UACG).
Methods:
This was a secondary analysis of the multicenter Consortium for Safe Labor dataset. This study included singleton, term deliveries with UACG available. Abnormal UACG was defined as pH≤7.0 or base excess >12 mmol/L. Odds Ratios were calculated using a multivariable logistic regression to determine clinical factors associated with abnormal UACG.
Results:
18,589 patients met inclusion criteria, with approximately 2% having an abnormal UACG. Those with prior Cesarean delivery (OR=1.49, 95% CI: 1.15-1.93), maternal diabetes (OR=1.67, 95% CI: 1.06-2.64), magnesium sulfate use (OR=1.81, 95% CI: 1.25-2.60), current Cesarean delivery (OR=2.56, 95% CI: 2.06-3.19), pre-eclampsia/HELLP (hemolysis, elevate liver enzymes, low platelet count) syndrome (OR=2.80, 95% CI: 1.79-4.36), and placental abruption (OR=4.81, 95% CI: 3.35-6.91) had increased odds of having abnormal UACG at delivery compared to those without.
Conclusions:
Diabetes, pre-eclampsia, placental abruption, and a history of prior Cesarean delivery were all associated with abnormal UACG in this cohort of singleton, term deliveries. These findings indicate that patients with pre-existing risk factors may be at an increased likelihood of adverse neonatal outcomes.
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