Lee Ji Hee, Jung Jihee, Park Hyea, Kim Seo-Yeon, Kwon Do Youn, Choi Suk-Joo, Oh Soo-Young, Roh Cheong-Rae
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2020 May;63(3):293-304. doi: 10.5468/ogs.2020.63.3.293. Epub 2020 Apr 13.
Given that the large volume of data on cord arterial blood gas analysis (ABGA) have been rarely addressed in Korean population, we aimed to examine the incidence, associated factors, and neonatal outcomes in cases of low cord pH, and investigate the incidence of cerebral palsy (CP).
From data of all consecutive term singleton pregnancies delivered in our institution from 2006 to 2016 (n=15,701), cases with cord ABGA (n=14,221) available were included. We collected information on maternal clinical characteristics and delivery outcomes and also examined neonatal and infant outcomes, including neonatal intensive care unit (NICU) admission and CP, in cases with low cord pH, defined as a pH <7.1.
Rates of low Apgar scores at 1 minute (<4) and 5 minutes (<7) were 0.6% (n=79) and 0.4% (n=58), respectively. Rates of cord pH <7.2, <7.1, and <7.0 were 7.1% (n=1,011), 1.1% (n=163), and 0.3% (n=38), respectively. Among cases with low cord pH, 30.1% (n=49/163) were admitted to the NICU and 11.0% (n=18/163) required ventilator support. Ultrasonography of the brain was performed in 28.8% (n=47/163), with abnormal findings observed in 27.7% (n=13/47). Among cases with low cord pH, 1.8% (n=3/163) were subsequently diagnosed with CP, including 2 cases of spastic CP and 1 of ataxic CP.
Although low cord pH was a relatively frequent finding observed in 1 out of every 87 cases, hypoxic-ischemic encephalopathy-related CP was found in only 1 out of 7,111 term singleton deliveries over 11 years in our institution.
鉴于韩国人群中关于脐动脉血气分析（ABGA）的大量数据很少被提及，我们旨在研究低脐动脉血pH值情况下的发生率、相关因素及新生儿结局，并调查脑瘫（CP）的发生率。
从2006年至2016年在我们机构分娩的所有连续足月单胎妊娠数据（n = 15,701）中，纳入有脐动脉血气分析数据（n = 14,221）的病例。我们收集了产妇临床特征和分娩结局的信息，并检查了低脐动脉血pH值（定义为pH < 7.1）病例的新生儿和婴儿结局，包括新生儿重症监护病房（NICU）入院情况和脑瘫情况。
1分钟时阿氏评分低（<4分）和5分钟时阿氏评分低（<7分）的发生率分别为0.6%（n = 79）和0.4%（n = 58）。脐动脉血pH < 7.2、< 7.1和< 7.0的发生率分别为7.1%（n = 1,011）、1.1%（n = 163）和0.3%（n = 38）。在低脐动脉血pH值的病例中，30.1%（n = 49/163）入住NICU，11.0%（n = 18/163）需要呼吸机支持。28.8%（n = 47/163）的病例进行了脑部超声检查，其中27.7%（n = 13/47）有异常发现。在低脐动脉血pH值的病例中，1.8%（n = 3/163）随后被诊断为脑瘫，包括2例痉挛型脑瘫和1例共济失调型脑瘫。
尽管低脐动脉血pH值在每87例中相对常见，但在我们机构11年期间的7,111例足月单胎分娩中，与缺氧缺血性脑病相关的脑瘫仅发现1例。
