NEONATAL COMPLICATIONS IN NEWBORNS WITH AN UMBILICAL ARTERY PH-LESS-THAN-7.00

OBJECTIVE: Our purpose was to determine the significance of an umbilic al artery pH <7.00 in relation to neonatal morbidity and mortality. ST UDY DESIGN: Between 1986 and 1993 acid-base assessment of the umbilica l artery was performed routinely in 10,699 deliveries. In a retrospect ive cohort study 84 nonanomalous neonates with an umbilical artery pH <7.00 were individually matched with 84 neonates with an umbilical art ery pH >7.24. Matched variables included year of delivery, gender, par ity, maternal age, delivery mode, fetal presentation, gestational age, and birth weight. Differences in morbidity between the two groups dur ing the neonatal period (until 28 days after delivery) were investigat ed. RESULTS: Neonates with an umbilical artery pH <7.00 versus >7.24 s howed significant differences in the following: neonatal condition dir ectly post partum; neurologic, respiratory, cardiovascular, and gastro intestinal complications; and neonatal intensive care unit admissions. No significance was found in renal dysfunction and mortality rate. Th e proportion of premature infants (<37 weeks) was 17% in both groups. In the acidotic group a 1-minute Apgar score less than or equal to 3 a nd a 5-minute Apgar score <7 was predictive for neonatal complications . CONCLUSIONS: Severe intrapartum asphyxia, quantified by an umbilical artery pH <7.00, poses a threat to the neonate's health.