Factors associated with umbilical artery acidemia in term infants with low Apgar scores at 5min

Abstract Background Umbilical artery cord blood gas (UACG) values and Apgar scores (AS) are the two parameters that provide the fastest information about the well-being of a baby after birth. We hypothesized that AS may not be sufficient for a complete and correct evaluation of the newborns and UACG should be used routinely for all births even without any signs of fetal distress. Material-methods In this retrospective study, the data of 1781 babies born between January 2018 and December 2019 at Cerrahpasa Faculty of Medicine were analyzed. Newborn with fetal distress, congenital anomalies, severe and moderate acidemia (pH ≤7.1 at UACG), and pre and postterm newborns are excluded. The UACG and the 1 and 5-minute AS data of 1438 cases were evaluated. Mild acidemia was accepted as a pH between 7.1 and 7.2. Following UACG threshold values were accepted as abnormal pH <7.2, BE <-6 mmol/l, lactate ≥5 mmol/l, HCO3 <18 mmol/l, pCO2 ≥50 mmHg. We evaluated the correlation between UACG and 1 and 5-minute AS and their effects on admission to neonatal intensive care unit (NICU). Results There was a significant correlation between both 1 and 5-minute AS and UACG values such as pH, lactate, and pCO 2 (p<0.001). In addition, significant correlation was found between the 5-minute AS below 7 and some UACG abnormal threshold values (pH, HCO 3 , base excess) (p<0.001). We found that some cases with mild acidemia had a normal 1 and 5-minute Apgar scores (AS≥7) in %1.9 and %2 of cases, respectively. A significant correlation was found between admissions to NICU with 1 and 5-minute AS of <7 (p<0.001). Conclusions The 5-minute AS of 7 or higher may not be sufficient to verify the well-being of a newborn. Relying only on AS, may create the risk of missing some newborns with mild metabolic acidosis. 1 and 5-minute AS could be used as a predictive value for NICU admission. We propose that routine UACG should be evaluated for each birth at term, even without any signs of fetal distress and normal AS.

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Characteristics of acidotic vs non-acidotic cases of low Apgar scores at 5 minutes in term infants

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2005.10.488 ◽

2005 ◽

Vol 193 (6) ◽

pp. S136

Author(s):

Alessandro Ghidini ◽

Maddalena Incerti ◽

Anna Locatelli ◽

Anna Longoni ◽

Elena Ciriello ◽

...

Keyword(s):

Term Infants ◽

Apgar Scores

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Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0217 ◽

2019 ◽

Vol 47 (7) ◽

pp. 683-688

Author(s):

Giuseppe Rizzo ◽

Cecilia Mattioli ◽

Ilenia Mappa ◽

Victoria Bitsadze ◽

Jamilya Khizroeva ◽

...

Keyword(s):

Prospective Study ◽

Cardiac Remodeling ◽

Uterine Artery ◽

Umbilical Artery ◽

Umbilical Vein ◽

Growth Restriction ◽

Cardiac Remodelling ◽

Special Care Unit ◽

Factors Associated ◽

A Prospective Study

Abstract Background Altered cardiac geometry affects a proportion of fetuses with growth restriction (FGR). The aim of this study was to explore the hemodynamic factors associated with cardiac remodeling in late FGR. Methods This was a prospective study of singleton pregnancies complicated by late-onset FGR undergoing assessment of left (LV) and right (RV) ventricular sphericity-index (SI). The study population was divided in two groups according to the presence of cardiac remodelling, defined as LVSI <5th centile. The following outcomes were explored: gestational age at birth, birthweight, caesarean section (CS) for fetal distress, umbilical artery (UA) pH and neonatal admission to special care unit. The differences between the 2 groups in UA pulsatility index (PI), middle cerebral artery (MCA) PI, uterine artery PI, cerebroplacental ratio (CPR) and umbilical vein (UV) flow corrected for fetal abdominal circumference (UVBF/AC) were tested. Results In total, 212 pregnancies with late FGR were enrolled in the study. An abnormal LV SI was detected in 119 fetuses (56.1%). Late FGR fetuses with cardiac remodeling had a lower birthweight (2390 g vs. 2490; P = 0.04) and umbilical artery pH (7.21 vs. 7.24; P = 0.04) and were more likely to have emergency CS (42.8% vs. 26.9%; P = 0.023) and admission to special care unit (13.4% vs. 4.3%; P = 0.03) compared to those with normal LVSI. No difference in either UA PI (p = 0.904), MCA PI (P = 0.575), CPR (P = 0.607) and mean uterine artery PI (P = 0.756) were present between fetuses with or without an abnormal LV SI. Conversely, UVBF/AC z-score was lower (−1.84 vs. −0.99; P ≤ 0.001) in fetuses with cardiac remodeling and correlated with LV (P ≤ 0.01) and RV SI (P ≤ 0.02). Conclusion Fetal cardiac remodelling occurs in a significant proportion of pregnancies complicated by late FGR and is affected by a high burden of short-term perinatal compromise. The occurrence of LV SI is independent from fetal arterial Dopplers while it is positively associated with umbilical vein blood flow.

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Factors associated with Posttraumatic Stress Disorder and Its Coping Styles in Parents of Preterm and Full-Term Infants

Global Journal of Health Science ◽

10.5539/gjhs.v6n3p65 ◽

2014 ◽

Vol 6 (3) ◽

Cited By ~ 16

Author(s):

Maryam Ghorbani ◽

Mahrokh Dolatian ◽

Jamal Shams ◽

Hamid Alavi-Majd ◽

Samira Tavakolian

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Coping Styles ◽

Full Term ◽

Term Infants ◽

Factors Associated

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7: EFM and peripartum factors associated with brain injury in term infants

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2014.10.038 ◽

2015 ◽

Vol 212 (1) ◽

pp. S5 ◽

Cited By ~ 4

Author(s):

Alison Cahill ◽

George Macones ◽

Robert McKinstry ◽

Christopher Smyser ◽

Amit Mathur

Keyword(s):

Brain Injury ◽

Term Infants ◽

Factors Associated

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Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2006.00911.x ◽

2006 ◽

Vol 113 (4) ◽

pp. 491-492 ◽

Cited By ~ 1

Author(s):

N-Y Boo ◽

Z Mahdy

Keyword(s):

Risk Factors ◽

Full Term ◽

Vacuum Extraction ◽

Term Infants ◽

Factors Associated

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Prognostic Markers in Term Infants with Hypoxic–Ischemic Encephalopathy: Comparative Analysis of MRI, EEG, and Apgar Scores

Journal of Pediatric Neurology ◽

10.1055/s-0037-1606367 ◽

2017 ◽

Vol 16 (01) ◽

pp. 008-014 ◽

Cited By ~ 1

Author(s):

Elissa Yozawitz ◽

Ajay Goenka

Keyword(s):

Hypoxic Ischemic Encephalopathy ◽

Neurological Deficits ◽

Term Infants ◽

Term Outcome ◽

Apgar Scores ◽

Long Term Outcome ◽

Perinatally Acquired ◽

Magnetic Resonance Imaging Mri ◽

Poor Outcomes ◽

Ischemic Encephalopathy

AbstractHypoxic–ischemic encephalopathy (HIE) is a frequent cause of perinatally acquired brain injury resulting in abnormal neurological consequences. In this retrospective study, we evaluated 68 neonates with clinical evidence of HIE to investigate the utility of magnetic resonance imaging (MRI), electroencephalography (EEG), and Apgar scores, individually and in combination, as predictors of long-term outcome. Six infants died during treatment, and 46 of the remaining 62 infants (74%) received follow-up neurological assessments at ages 6 to 24 months. The outcome was dichotomously classified as good (reflecting “normal development”) or as poor (reflecting “neurological deficits” based upon attainment of developmental milestones or death). Abnormal Apgar scores, MRIs, and EEGs had sensitivities of 50, 84, and 95% for predicting “neurological deficit.” Corresponding specificities were 85, 66, and 18%. However, the combination of abnormal Apgar scores, MRIs, and EEGs in predicting poor outcomes (i.e., “neurological deficits” or death) had sensitivity and specificity of 100%. In addition, the combination of abnormal Apgar scores, MRIs, and EEGs provided a positive predictive value of 100% in assessing poor outcome as compared with 73% (p = 0.2) for Apgar scores, 71% (p = 0.01) for MRIs, and 56% (p = 0.001) for EEGs.

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