PREDICTIVE VALUE OF UMBILICAL ARTERY PH IN PRETERM INFANTS

Compared with term infants, little information is available about the usefulness of the umbilical artery pH in relation to outcome in extrem ely preterm infants. This prospective study evaluates the relation bet ween umbilical artery pH (UapH), Apgar scores, perinatal events, and o utcome in infants born at less than 32 weeks' gestation. Six hundred a nd twenty three infants of <32 weeks' gestation were studied. The medi an UapH was 7.25, with a range of 6.78-7.49. A low UapH was significan tly associated with male sex, hyaline membrane disease, grade 3 or 4 i ntraventricular haemorrhage, and neonatal death. It was also associate d with lower birth weight and lower birthweight centile. The relations between the UapH and outcomes of neonatal death, cerebral palsy, and developmental quotient at 1 year, and other perinatal risk factors wer e then examined using multiple logistic regression. After adjusting fo r other risk factors, UapH was not significantly associated with any o utcome. In contrast, a low one minute Apgar (<4) remained a significan t risk factor, with odds ratios of 2.7 (95% confidence interval (CI) 1 .5 to 5.2) for neonatal death and 3.8 (95% CI 1.4 to 10.4) for cerebra l palsy.