title: Severe fetal acidemia in cases of clinical chorioamnionitis in which the infant later developed cerebral palsy.
abstract: BACKGROUND
  The umbilical arterial pH (UApH) in cases of clinically apparent chorioamnionitis (CAM) in which the infant later develop severe cerebral palsy (CP) has not yet been fully investigated. The objective of this study was to determine the UApH in CAM cases in which the infant later develop severe CP.
  
  
  METHODS
  A review was conducted unti1 April 2014 among 324 infants with CP diagnosed to be caused by antenatal and/or intrapartum conditions, as determined by the Japan Council for Quality Health Care. Eighty-six infants born at over 34 weeks of gestation with an abnormal FHR pattern during labor were selected. The subjects were divided into the following two groups: cases with (Group I, n = 19) and those without (Group II, n = 67) clinical CAM. Severe fetal acidemia was defined as a pH of less than 7.0.
  
  
  RESULTS
  The frequency of severe acidemia in Groups 1 and II was 26.3 and 74.6 %, respectively. In addition, the frequency of severe acidemia was significantly less in Group I (odds ratio (OR) 0.12, 95 % confidence interval (CI) 0.03-0.53) than in Group II, while the frequency of fetal tachycardia was greater in Group I (OR 7.61, 95 % CI 1.82-31.7) than in Group II, after adjusting for confounding effects.
  
  
  CONCLUSIONS
  The frequency of severe acidemia was lower in the cases of clinical CAM in which the infant later developed severe cerebral palsy than in the cases without clinical CAM. The relation of fetal tachycardia to CP with clinical CAM, but not to acidemia, should be reevaluated in such cases.
authors.affiliation: Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763, Tochigi, Japan. yoshiom2979@gmail.com.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Kawada-cho, 8-1, Shinjuku-ku, 162-8666, Tokyo, Japan. masakiogawa@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Obstetrics and Gynecology, Tama-Nagayama Hospital, Nippon Medical School 1-7-1 Nagayama, Tama-City, 206-8512, Tokyo, Japan. nakai-3@nms.ac.jp.
authors.forename: Akihito
authors.initials: A
authors.lastname: Nakai
authors.affiliation: Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763, Tochigi, Japan. t-miki@iuhw.ac.jp.
authors.forename: Miki
authors.initials: M
authors.lastname: Tagawa
authors.affiliation: Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763, Tochigi, Japan. mohwada@iuhw.ac.jp.
authors.forename: Michitaka
authors.initials: M
authors.lastname: Ohwada
authors.affiliation: Department of Obstetrics and Gynecology, Miyazaki Medical Association Hospital, 738-1, Funado, Shinbeppuchou, Miyazaki-city, 880-0834, Japan. tsuyomu_ikenoue@med.miyazaki-u.ac.jp.
authors.forename: Tsuyomu
authors.initials: T
authors.lastname: Ikenoue
mesh_terms: D000138:Acidosis / Q000097:blood / Q000150:complications*; D002547:Cerebral Palsy / Q000209:etiology*; D002821:Chorioamnionitis / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D007743:Labor, Obstetric; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D014469:Umbilical Arteries / Q000737:chemistry