Severe acidosis and subsequent neurologic status.
To examine the relationship between severe acidosis at birth and evidence of subsequent neurologic dysfunction, a 4-year review was performed encompassing 15,528 neonates. One hundred forty-two (0.91%) of these neonates had an umbilical cord arterial pH less than or equal to 7.05 with a base deficit greater than or equal to mEq/L. Neurologic assessments found 101 of 110 term neonates (91.8%) and 17 of 32 preterm neonates (53.1%) with severe acidosis to be free of neurologic deficits at the time of hospital discharge. Follow-up developmental evaluation data were available for 7 of 9 term neonates and 8 of 15 preterm neonates with abnormal examinations. Although 5 term and 6 preterm infants demonstrated mild developmental delays or mild tone abnormalities in the first year of life, none exhibited a major motor or cognitive abnormality at 12 to 24 months of age. Consequently, acidosis in umbilical cord blood, even when severe, is a poor predictor of subsequent neurologic dysfunction.
Fee
S C
SC
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
Malee
K
K
Deddish
R
R
Minogue
J P
JP
Socol
M L
ML
D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000097:blood / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000097:blood; D002657:Child Development; D036861:Delivery, Obstetric; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn / Q000254:growth & development; D009420:Nervous System / Q000503:physiopathology*; D009460:Neurologic Examination; D010313:Partial Pressure; D013997:Time Factors
D002245:Carbon Dioxide