Low J A, Lindsay B G, Derrick E J
Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.
Am J Obstet Gynecol. 1997 Dec;177(6):1391-4. doi: 10.1016/s0002-9378(97)70080-2.
Our purpose was to determine the threshold of metabolic acidosis at delivery associated with newborn complications.
This study was a matched case-control study of 174 term newborn infants. Three groups defined by umbilical artery base deficit at birth were 4 to 8 mmol/L, 8 to 12 mmol/L, and 12 to 16 mmol/L. Newborn complications during the 5 days after birth were documented. A composite complication score defined the magnitude of all complications in each neonate.
Moderate and severe newborn encephalopathy and respiratory complications and composite complication scores >3 were increased in the group with an umbilical artery base deficit of 12 to 16 mmol/L. Moderate or severe newborn complications occurred in 10% of newborns in the same group, whereas such complications occur in 40% of neonates with an umbilical artery base deficit >16 mmol/L at birth.
The threshold of fetal metabolic acidosis at delivery when moderate or severe newborn complications may occur is in an umbilical artery base deficit of 12 mmol/L. Thereafter, increasing metabolic acidosis is associated with a progression of severity of newborn complications.
