title: Impact of metabolic acidemia at birth on neonatal outcomes in infants born before 34 weeks' gestation.
abstract: OBJECTIVE
  To examine prematurity-associated neonatal outcomes in early preterm infants with metabolic acidemia compared to those without such acidemia.
  
  
  METHODS
  We performed a retrospective cohort analysis to assess the impact of metabolic acidemia on prematurity-associated complications in a large cohort of singleton live-born infants with complete umbilical cord gas analyses delivered between 24 0/7 and 33 6/7 weeks. Metabolic acidemia was defined as an umbilical artery pH less than 7.0 plus a base deficit of 12 mmol/L or greater. Outcomes were adjusted for gestational age using logistic regression.
  
  
  RESULTS
  Between 1 January 1988 and 31 December 2014, 6970 singleton early preterm infants were delivered at our hospital, of which 126 (1.8%) had metabolic acidemia. Neonatal mortality as well as prematurity-associated morbidities were significantly increased in the presence of metabolic acidemia. Included were ventilator requirement (73% versus 36%, p < 0.001), grade 3/4 intraventricular hemorrhage (10% versus 4%, p < 0.001), periventricular leukomalacia (5% versus 2%, p = 0.036), and neonatal death (13% versus 4%, p < 0.001). These significant findings persisted after adjustment for gestational age.
  
  
  CONCLUSIONS
  Metabolic acidemia significantly increases the risks related to prematurity in infants delivered prior to 34 weeks' gestation.
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Jamie L
authors: JL
authors: Morgan
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: David B
authors: DB
authors: Nelson
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Brian M
authors: BM
authors: Casey
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Steven L
authors: SL
authors: Bloom
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Donald D
authors: DD
authors: McIntire
authors: a Department of Obstetrics and Gynecology , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Kenneth J
authors: KJ
authors: Leveno
mesh_terms: D000138:Acidosis / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: Metabolic acidemia; early preterm birth; prematurity-associated morbidity