title: Severe umbilical cord acidemia and neurological outcome in preterm and full-term neonates.
abstract: BACKGROUND
  Severe intrauterine hypoxia-ischemia and acidemia may lead to a disturbed neurodevelopment.
  
  
  OBJECTIVE
  To study the effects of acidemia at birth on neurodevelopment in preterm and full-term neonates.
  
  
  METHODS
  Short- and long-term outcome were studied retrospectively in 44 inborn preterms and 95 full-terms with severe acidemia at birth defined as a pH of the umbilical artery <7.00. Outcome was compared with 67 preterm and 90 full-term non-acidemic neonates (pH>7.15). Intraventricular hemorrhage (preterms) or seizures (both preterms and full-terms) were considered an adverse short-term outcome. Neonatal death, cerebral palsy or neurodevelopmental delay were considered an adverse long-term outcome.
  
  
  RESULTS
  Severe intraventricular hemorrhage (IVH) occurred in 5 of the 44 (11%) acidemic preterms and in none of the 67 (0%) non-acidemic preterms (p<0.01). Seizures were observed in 9 of the 44 (20%) and 11 of the 95 (12%) acidemic preterms and full-terms, respectively, and in none of the 67 (0%) and 1 of the 90 (1%) non-acidemic preterms and full-terms, respectively (p<0.001 for preterms, p<0.01 for full-terms). Nine preterms (6 acidemic, 3 non-acidemic) and 2 full-terms (both acidemic) died in the neonatal period. Adverse long-term outcome occurred in 32% of the acidemic preterms, in 21% of the non-acidemic preterms, in 7% of the acidemic full-terms and in 7% of the non-acidemic full-terms.
  
  
  CONCLUSIONS
  Acidemia at birth increased the occurrence of severe IVH in preterm neonates and seizures in both preterm and full-term neonates. However, no significant effect of acidemia on long-term outcome could be demonstrated.
authors.affiliation: Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Selma W
authors.initials: SW
authors.lastname: Lavrijsen
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Robert H
authors.initials: RH
authors.lastname: Stigter
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Gerard H A
authors.initials: GH
authors.lastname: Visser
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
mesh_terms: D000138:Acidosis / Q000097:blood*; D002543:Cerebral Hemorrhage / Q000097:blood; D002657:Child Development; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020925:Hypoxia-Ischemia, Brain / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood*; D011247:Pregnancy; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood; D011795:Surveys and Questionnaires