title: Poor neonatal acid-base status in term fetuses with low cerebroplacental ratio.
abstract: OBJECTIVE
  To determine whether small- and appropriate-for-gestational-age (SGA and AGA) term fetuses with a low cerebroplacental ratio (CPR) have worse neonatal acid-base status than those with normal CPR.
  
  
  METHODS
  This was a retrospective study of 2927 term fetuses divided into groups according to birth-weight centile and CPR multiple of the median. The acid-base status at birth as determined by arterial and venous umbilical cord blood pH was compared between weight-centile groups with and without low CPR.
  
  
  RESULTS
  CPR was better correlated with umbilical cord blood pH (arterial pH, r(2)  = 0.008, P < 0.0001 and venous pH, r(2)  = 0.01, P < 0.0001) than was birth weight (arterial pH, r(2)  = 0.001, P =0.180 and venous pH, r(2)  = 0.005, P < 0.001). AGA fetuses with low CPR were more academic than were those with normal CPR (P = 0.0359 and 0.0006, respectively, for arterial and venous pH).
  
  
  CONCLUSIONS
  The findings of this study demonstrate that low CPR in AGA fetuses is an equally important marker of low neonatal pH secondary to placental underperfusion as is being SGA. Although the relative importance of low CPR and birth weight in identifying pregnancies at risk of placental hypoxemia and adverse fetal and neonatal outcome remains to be determined, this finding may be of particular value in the prediction and prevention of stillbirth and long-term neurodevelopmental disability.
authors.affiliation: Servicio de Obstetricia y Ginecologia, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Morales-Roselló
authors.forename: A
authors.initials: A
authors.lastname: Khalil
authors.forename: M
authors.initials: M
authors.lastname: Morlando
authors.forename: A
authors.initials: A
authors.lastname: Bhide
authors.forename: A
authors.initials: A
authors.lastname: Papageorghiou
authors.forename: B
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D005312:Fetal Blood / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal / Q000379:methods; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: cerebroplacental ratio; cord pH; failure to reach growth potential; fetal Doppler; fetal acid-base status; fetal growth restriction