Lin Y S, Chang F M, Liu C H
Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C.
J Formos Med Assoc. 1992 Apr;91(4):396-9.
A prospective study of umbilical arterial blood gas in appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) babies was performed at our hospital from August 1989 to July 1990. A total of of 512 cases were included, 432 cases in the AGA group and 80 cases in the SGA group, with gestational ages ranging from 26 to 42 weeks. Umbilical arterial blood was collected immediately after delivery of the newborns. Comparisons of maternal age, gestational age, birth body weight and body length of infants. Apgar scores at one minute and five minutes, cord arterial blood pH, pO2, pCO2, base excess, bicarbonate, total CO2, O2 saturation and O2 content between the AGA and SGA groups were taken into account. Our results demonstrated significant differences in birth body weight, birth body length, Apgar scores at one minute and five minutes and gestational age in the SGA group compared with those in the AGA group. The parameters of cord arterial blood gas were not correlated with gestational age in either group. The mean pH value in the AGA group (7.30 +/- 0.05) was higher than that in the SGA group (7.28 +/- 0.08). The same trend of difference was also noted between the AGA (7.30 +/- 0.04) and SGA (7.27 +/- 0.07) babies who were delivered by Cesarean section (p < 0.05). The latter results imply a more academic state in SGA babies which is independent of labor. Prepartum asphyxia plays an important role in determining the prognosis of SGA babies. We suggest routine umbilical cord blood gas and acid-base analysis at delivery to assess fetal asphyxia.
1989年8月至1990年7月，我院对适于胎龄（AGA）和小于胎龄（SGA）婴儿的脐动脉血气进行了一项前瞻性研究。共纳入512例病例，AGA组432例，SGA组80例，胎龄范围为26至42周。新生儿出生后立即采集脐动脉血。比较两组产妇年龄、胎龄、婴儿出生体重和身长、1分钟和5分钟Apgar评分、脐动脉血pH值、pO2、pCO2、碱剩余、碳酸氢盐、总CO2、O2饱和度和O2含量。结果显示，与AGA组相比，SGA组的出生体重、出生身长、1分钟和5分钟Apgar评分及胎龄存在显著差异。两组脐动脉血气参数均与胎龄无关。AGA组的平均pH值（7.30±0.05）高于SGA组（7.28±0.08）。剖宫产分娩的AGA（7.30±0.04）和SGA（7.27±0.07）婴儿之间也存在同样的差异趋势（p<0.05）。后一结果表明SGA婴儿存在更严重的酸中毒状态，且与产程无关。产前窒息在决定SGA婴儿的预后中起重要作用。我们建议在分娩时常规进行脐动脉血气和酸碱分析以评估胎儿窒息情况。
