Severe acidosis and subsequent neurologic status
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Cited by (116)
Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility
2023, American Journal of Obstetrics and GynecologyThreshold of metabolic acidosis associated with newborn cerebral palsy: medical legal implications
2019, American Journal of Obstetrics and GynecologyCitation Excerpt :Studies that have reported scoring systems for the prediction of neonatal morbidity after acute perinatal asphyxia have not demonstrated a predictive value of increasing umbilical artery BD but rather use only the threshold BD.57–60 In fact, several studies emphasize that the degree of fetal acidemia does not correlate with long-term neurodevelopmental sequela.61–63 A recent metaanalysis of the strength of the association between umbilical cord acidosis and both perinatal and long-term outcomes64 demonstrated that a low arterial cord pH (defined as <7.0–7.2) was associated with the development of cerebral palsy but failed to demonstrate any dose-response association of the degree of acidosis with the rate of occurrence or severity of cerebral palsy.
Intrauterine, Intrapartum Assessments in the Term Infant
2018, Volpe's Neurology of the NewbornPathophysiology of Birth Asphyxia
2016, Clinics in PerinatologyCitation Excerpt :The majority of these infants (>60%) have an uneventful delivery, remain in the well nursery, and are discharged home without complication.36 Even when infants with severe fetal acidemia are admitted to intensive care (usually because of respiratory difficulties) about 80% to 90% exhibit a benign neurologic course and it is only a small percentage present with encephalopathy.37–39 In 1 study, 8 of 47 infants (12%) with severe fetal acidemia admitted to the intensive care unit developed HIE, including seizures.37
Cerebral palsy and perinatal asphyxia (II - Medicolegal implications and prevention)
2011, Gynecologie Obstetrique et FertiliteA systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy
2008, American Journal of Obstetrics and GynecologyCitation Excerpt :Prior studies that have failed to show a correlation between umbilical arterial pH at birth and neonatal neurologic abnormalities failed to look specifically at those neonates with pH < 7.0.46-48 When 110 term infants with pH < 7.05 and base deficit > 10 mM were examined, it was found that 5 demonstrated mild developmental delays or mild tone abnormalities in the first year of life, but none exhibited a major motor or cognitive abnormality at 12-24 months of age.48 They concluded that even severe acidosis in umbilical cord blood is insufficient evidence of intrapartum hypoxia-ischemia profound enough to cause neurologic damage and that most mild neurologic deficits noted in an infant after severe acidosis can be expected to resolve in the first year of life, but they did not look specifically at neonates with pH < 7.0 or base deficit > 12 mM, the cutoffs that have been linked with an increased risk of neurologic complications.