Doğan Kocabıyık Nazan N, Salihoğlu Ozgul
Department of Pediatrics, Division of Neonatology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TUR.
Cureus. 2024 Jun 14;16(6):e62362. doi: 10.7759/cureus.62362. eCollection 2024 Jun.
Introduction Intrapartum hypoxic-ischemic injury is a condition that significantly affects neonatal health and, therefore, needs to be attended to urgently. Umbilical cord blood gas analysis (BGA) results and APGAR (appearance, pulse, grimace, activity, and respiration) scores are commonly used to assess birth asphyxia and the severity of neonatal acidemia. In this context, this study was conducted to investigate the correlations of BGA results and APGAR scores with neonatal outcomes to determine the combined value of BGA results and APGAR scores in neonatal health assessment. Methods The sample of this retrospective cohort study consisted of 593 consecutive-term newborns delivered in a tertiary referral center in Turkey between January 2020 and December 2022. All newborns' maternal, delivery, and neonatal characteristics, BGA results, and APGAR scores were analyzed to determine correlations with composite adverse neonatal outcomes. The study's primary outcome was defined as the rate of the composite adverse neonatal outcomes, whereas the secondary outcomes were determined as the impact of maternal and neonatal characteristics on composite neonatal morbidity and the correlation between the one- and five-minute APGAR scores and umbilical cord BGA parameters. Results Of the 593 infants included in the study, 191 (32.2%) infants experienced composite adverse neonatal outcomes, primarily mechanical ventilation (47.7%), followed by respiratory distress/syndrome (35.6%). Significant correlations were detected between composite adverse neonatal outcomes and advanced maternal age (p = 0.025), cesarean section history (p < 0.001), preterm delivery (p < 0.001), lower one- and five-minute APGAR scores (p < 0.001 for both cases), and acidemia severity (p = 0.007). However, the correlations between BGA parameters and APGAR scores were weak (r < 0.2). Conclusion This study investigated the correlations between neonatal mortality and morbidity and maternal factors, delivery characteristics, and fetal features, including one- and five-minute APGAR scores and BGA parameters. Nevertheless, weak correlations between BGA parameters and APGAR scores warrant further comprehensive prospective studies.
引言 产时缺氧缺血性损伤是一种严重影响新生儿健康的病症，因此需要紧急处理。脐血气分析（BGA）结果和阿氏评分（外观、脉搏、 grimace（此处可能有误，推测应为“ grimace反射”，即“皱眉动作”）、活动和呼吸）常用于评估出生窒息及新生儿酸血症的严重程度。在此背景下，本研究旨在探讨BGA结果和阿氏评分与新生儿结局的相关性，以确定BGA结果和阿氏评分在新生儿健康评估中的综合价值。
方法 本回顾性队列研究的样本包括2020年1月至2022年12月期间在土耳其一家三级转诊中心连续足月分娩的593名新生儿。分析所有新生儿的母亲、分娩及新生儿特征、BGA结果和阿氏评分，以确定与复合不良新生儿结局的相关性。该研究的主要结局定义为复合不良新生儿结局的发生率，而次要结局则确定为母亲和新生儿特征对复合新生儿发病率的影响以及1分钟和5分钟阿氏评分与脐血BGA参数之间的相关性。
结果 在纳入研究的593名婴儿中，191名（32.2%）婴儿经历了复合不良新生儿结局，主要是机械通气（47.7%），其次是呼吸窘迫/综合征（35.6%）。在复合不良新生儿结局与高龄产妇（p = 0.025）、剖宫产史（p < 0.001）、早产（p < 0.001）、较低的1分钟和5分钟阿氏评分（两种情况p均< 0.001）以及酸血症严重程度（p = 0.007）之间检测到显著相关性。然而，BGA参数与阿氏评分之间的相关性较弱（r < 0.2）。
结论 本研究调查了新生儿死亡率和发病率与母亲因素、分娩特征以及胎儿特征（包括1分钟和五分钟阿氏评分及BGA参数）之间的相关性。尽管如此，BGA参数与阿氏评分之间的弱相关性仍需要进一步全面的前瞻性研究。
