title: Perinatal pH and neuropsychological outcomes at age 3 years in children born preterm: an exploratory study.
abstract: The impact of extreme prematurity and related hypoxic-ischemic events on brain development recently has begun to be characterized with modern neuroimaging methods, although comparatively less is known about the neuropathology in those born at heavier birth weights. Even subclinical levels of perinatal hypoxia-ischemia, as indexed by perinatal blood pH, are related to intelligence in school-aged children born preterm. Given the impact of hypoxia-ischemia on white matter and the emerging evidence of specific executive and mathematic deficits in children born preterm, the impact of perinatal hypoxia-ischemia on these outcomes was explored in children at relatively low-risk for sequelae. In a sample of 22 preschool children born preterm, arterial blood pH values obtained within the first 3 h of life were abstracted from review of hospital medical charts, and then related to specific cognitive task performance at age 3 years. Mean initial pH was in the normal to subclinical range. Initial pH appears to be a strong predictor of specific mathematics and controlled attention abilities, and is not limited to general verbal ability alone. However, initial pH was not related to performance on measures of motor impulsivity or working memory. As a screening index of subtle hypoxia-ischemia, these findings suggest that perinatal arterial blood pH warrants further study as a potential marker of subtle hypoxic-ischemic injury that likely affects cognitive outcome throughout childhood in those at risk due to preterm birth.
authors.affiliation: Office of Research and Department of Psychology, University of Nebraska, Lincoln, NE 68588-0433, USA. kespy2@unl.edu
authors.forename: Kimberly Andrews
authors.initials: KA
authors.lastname: Espy
authors.forename: Theresa E
authors.initials: TE
authors.lastname: Senn
authors.forename: David A
authors.initials: DA
authors.lastname: Charak
authors.forename: Jill
authors.initials: J
authors.lastname: Tyler
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Wiebe
mesh_terms: D001774:Blood Chemical Analysis; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000453:epidemiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008297:Male; D009483:Neuropsychological Tests; D010500:Perinatology; D012720:Severity of Illness Index