Neonatal organ dysfunction among newborns at gestational age 34 weeks and umbilical arterial pH<7.00.
OBJECTIVE
Among newborns at 34 weeks or more with umbilical arterial pH<7.00, we endeavoured to determine the pH threshold and risk factors for neonatal organ injury within 72 hours of birth.


METHODS
Retrospectively, all non-anomalous newborns delivered over 6 years near term with a low pH were identified. Each case of a newborn with injury was compared with the next four neonates with a pH below 7.00 and no injury. A receiver-operating characteristic (ROC) curve and unconditional logistic regression was used.


RESULTS
Of the 87 newborns with pathologic acidosis, 16% had neonatal organ system injury. Inspection of the ROC curve indicates that a pH of 6.92 is the threshold that identifies newborns who will have damage to organs. Unconditional logistic regression analysis indicates that the significant risk factors for morbidity were an Apgar score <or=7 at 5 minutes, an UA pH <or=6.92, a sentinel event, and a history of maternal seizures among those at 37 weeks or more.


CONCLUSIONS
Among newborns at >or=37 weeks, pH <or=6.92 is the threshold linked with neonatal organ dysfunction.
Chauhan
Suneet P
SP
Spartanburg Regional Medical Center, Spartanburg, South Carolina 29303, USA. schauhan@srhs.com
Hendrix
Nancy W
NW
Magann
Everett F
EF
Sanderson
Maureen
M
Bofill
James A
JA
Briery
Christian M
CM
Morrison
John C
JC
D000137:Acid-Base Imbalance / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D001927:Brain Diseases / Q000401:mortality / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006331:Heart Diseases / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007226:Infant Mortality; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000401:mortality / Q000503:physiopathology*; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000503:physiopathology*; D012189:Retrospective Studies; D014469:Umbilical Arteries