title: Short term outcome of term newborns with unexpected umbilical cord arterial pH between 7.000 and 7.100.
abstract: BACKGROUND
  The relationship between cord arterial pH (CA-pH) > 7.000 and the neonatal outcome is not clear.
  
  
  OBJECTIVE
  To evaluate if asymptomatic infants born with unexpected cord arterial pH (CA-pH) between 7.000 and 7.100 develop clinical, biochemical, and instrumental signs of hypoxic cerebral, renal, and heart failure more frequently than symptomatic infants.
  
  
  METHODS
  Term infants with CA-pH of 7.000-7.100 and appropriate birth weight were prospectively and consecutively enrolled and classified as asymptomatic, when they had no resuscitation, early respiratory distress or early abnormal neurologic signs, and symptomatic infants. Clinical, biochemical, and instrumental signs of hypoxic cerebral, renal, and heart failure were evaluated in the two groups.
  
  
  RESULTS
  A total of 53 infants were enrolled. Twenty-eight (53%) were asymptomatic. CA-pH was similar in both the groups, while the cTnI serum concentration in the first day of life and the occurrence of poor feeding were higher in the symptomatic than in asymptomatic infants. An arterial lactate level of ≥ 4.1 mmol/l measured in the first hour of life was an independent risk factor for the development of a symptomatic course.
  
  
  CONCLUSIONS
  In our population the majority of infants born with a CA-pH between 7.000 and 7.100 were asymptomatic and would not have needed immediate admission to the neonatal care unit. Symptomatic infants showed a higher occurrence of subclinical heart injury and poor feeding.
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy. Electronic address: cdani@unifi.It.
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bresci
authors.forename: Elettra
authors.initials: E
authors.lastname: Berti
authors.forename: Silvia
authors.initials: S
authors.lastname: Lori
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Di Tommaso
authors.forename: Simone
authors.initials: S
authors.lastname: Pratesi
mesh_terms: D000138:Acidosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D001784:Blood Gas Analysis; D004562:Electrocardiography; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D016015:Logistic Models; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*; D018709:Statistics, Nonparametric
chemical_list: D019344:Lactic Acid
keywords: Cord pH; Hypoxic damage; Infant; Neonatal admission; Outcome