The effects of profound umbilical artery acidemia in term neonates admitted to a newborn nursery

T. A. King, G. L. Jackson, S. Josey, D. A. Vedro, H. Hawkins, K. M. Burton, M. N. Burks, Mary W Yellin, A. R. Laptook

Research output: Contribution to journalArticle

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Abstract

Objective: To determine whether there were immediate adverse effects of an umbilical artery pH ≤ 7.0 in term and near-term infants. Study design: All infants triaged to the newborn nursery with an umbilical artery pH ≤ 7.0 from May 1993 through April (n = 37) were prospectively identified; 35 of the 37 infants were enrolled and matched with nonacademic control infants (n = 35). Organ system dysfunction (neurologic, renal, hepatic, gastrointestinal) was evaluated either clinically or biochemically with selected blood and urine parameters. Results: Acidemic and control groups were similar for pregnancy complications before labor, but acidemic infants were more often delivered by cesarean section (20/35 vs 6/35, p = 0.001). No differences existed between acidemic and control infants in gestational age, birth weight, neurologic evaluations, hearing deficits, feeding tolerance, and hepatic function. The acidemic group had a higher mean serum creatinine than control infants on day 2 of life (0.90 ± 0.34 vs 0.71 ± 0.12 mg/dl, p = 0.005) and a greater number of infants with a urine Chemstrip positive for heme (14/35 vs 3/35, p = 0.005). No differences existed between groups in time to first void, urine specific gravity, and number of infants with microscopic hematuria. Conclusion: Term and near-term infants born with an umbilical artery pH ≤ 7.0 and triaged to the newborn nursery on the basis of a stable appearance in the delivery room do not have clinical manifestations of hypoxia-ischemia in the 48 hours after birth. The higher mean serum creatinine for acidemic compared with control groups is presumably prerenal in origin and results from processes responsible for profound fetal acidemia. Infants with an umbilical artery pH ≤ 7.0 and assessed to be clinically well can be treated similar to nonacidemic infants.

Original languageEnglish (US)
Pages (from-to)624-649
Number of pages26
JournalJournal of Pediatrics
Volume132
Issue number4
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Umbilical Arteries
Nurseries
Newborn Infant
Urine
Creatinine
Delivery Rooms
Control Groups
Specific Gravity
Pregnancy Complications
Liver
Hematuria
Neurologic Manifestations
Serum
Heme
Birth Weight
Cesarean Section
Nervous System
Hearing
Gestational Age
Ischemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

King, T. A., Jackson, G. L., Josey, S., Vedro, D. A., Hawkins, H., Burton, K. M., ... Laptook, A. R. (1998). The effects of profound umbilical artery acidemia in term neonates admitted to a newborn nursery. Journal of Pediatrics, 132(4), 624-649. https://doi.org/10.1016/S0022-3476(98)70350-6

The effects of profound umbilical artery acidemia in term neonates admitted to a newborn nursery. / King, T. A.; Jackson, G. L.; Josey, S.; Vedro, D. A.; Hawkins, H.; Burton, K. M.; Burks, M. N.; Yellin, Mary W; Laptook, A. R.

In: Journal of Pediatrics, Vol. 132, No. 4, 1998, p. 624-649.

Research output: Contribution to journalArticle

King, TA, Jackson, GL, Josey, S, Vedro, DA, Hawkins, H, Burton, KM, Burks, MN, Yellin, MW & Laptook, AR 1998, 'The effects of profound umbilical artery acidemia in term neonates admitted to a newborn nursery', Journal of Pediatrics, vol. 132, no. 4, pp. 624-649. https://doi.org/10.1016/S0022-3476(98)70350-6
King, T. A. ; Jackson, G. L. ; Josey, S. ; Vedro, D. A. ; Hawkins, H. ; Burton, K. M. ; Burks, M. N. ; Yellin, Mary W ; Laptook, A. R. / The effects of profound umbilical artery acidemia in term neonates admitted to a newborn nursery. In: Journal of Pediatrics. 1998 ; Vol. 132, No. 4. pp. 624-649.
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abstract = "Objective: To determine whether there were immediate adverse effects of an umbilical artery pH ≤ 7.0 in term and near-term infants. Study design: All infants triaged to the newborn nursery with an umbilical artery pH ≤ 7.0 from May 1993 through April (n = 37) were prospectively identified; 35 of the 37 infants were enrolled and matched with nonacademic control infants (n = 35). Organ system dysfunction (neurologic, renal, hepatic, gastrointestinal) was evaluated either clinically or biochemically with selected blood and urine parameters. Results: Acidemic and control groups were similar for pregnancy complications before labor, but acidemic infants were more often delivered by cesarean section (20/35 vs 6/35, p = 0.001). No differences existed between acidemic and control infants in gestational age, birth weight, neurologic evaluations, hearing deficits, feeding tolerance, and hepatic function. The acidemic group had a higher mean serum creatinine than control infants on day 2 of life (0.90 ± 0.34 vs 0.71 ± 0.12 mg/dl, p = 0.005) and a greater number of infants with a urine Chemstrip positive for heme (14/35 vs 3/35, p = 0.005). No differences existed between groups in time to first void, urine specific gravity, and number of infants with microscopic hematuria. Conclusion: Term and near-term infants born with an umbilical artery pH ≤ 7.0 and triaged to the newborn nursery on the basis of a stable appearance in the delivery room do not have clinical manifestations of hypoxia-ischemia in the 48 hours after birth. The higher mean serum creatinine for acidemic compared with control groups is presumably prerenal in origin and results from processes responsible for profound fetal acidemia. Infants with an umbilical artery pH ≤ 7.0 and assessed to be clinically well can be treated similar to nonacidemic infants.",
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AU - King, T. A.

AU - Jackson, G. L.

AU - Josey, S.

AU - Vedro, D. A.

AU - Hawkins, H.

AU - Burton, K. M.

AU - Burks, M. N.

AU - Yellin, Mary W

AU - Laptook, A. R.

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N2 - Objective: To determine whether there were immediate adverse effects of an umbilical artery pH ≤ 7.0 in term and near-term infants. Study design: All infants triaged to the newborn nursery with an umbilical artery pH ≤ 7.0 from May 1993 through April (n = 37) were prospectively identified; 35 of the 37 infants were enrolled and matched with nonacademic control infants (n = 35). Organ system dysfunction (neurologic, renal, hepatic, gastrointestinal) was evaluated either clinically or biochemically with selected blood and urine parameters. Results: Acidemic and control groups were similar for pregnancy complications before labor, but acidemic infants were more often delivered by cesarean section (20/35 vs 6/35, p = 0.001). No differences existed between acidemic and control infants in gestational age, birth weight, neurologic evaluations, hearing deficits, feeding tolerance, and hepatic function. The acidemic group had a higher mean serum creatinine than control infants on day 2 of life (0.90 ± 0.34 vs 0.71 ± 0.12 mg/dl, p = 0.005) and a greater number of infants with a urine Chemstrip positive for heme (14/35 vs 3/35, p = 0.005). No differences existed between groups in time to first void, urine specific gravity, and number of infants with microscopic hematuria. Conclusion: Term and near-term infants born with an umbilical artery pH ≤ 7.0 and triaged to the newborn nursery on the basis of a stable appearance in the delivery room do not have clinical manifestations of hypoxia-ischemia in the 48 hours after birth. The higher mean serum creatinine for acidemic compared with control groups is presumably prerenal in origin and results from processes responsible for profound fetal acidemia. Infants with an umbilical artery pH ≤ 7.0 and assessed to be clinically well can be treated similar to nonacidemic infants.

AB - Objective: To determine whether there were immediate adverse effects of an umbilical artery pH ≤ 7.0 in term and near-term infants. Study design: All infants triaged to the newborn nursery with an umbilical artery pH ≤ 7.0 from May 1993 through April (n = 37) were prospectively identified; 35 of the 37 infants were enrolled and matched with nonacademic control infants (n = 35). Organ system dysfunction (neurologic, renal, hepatic, gastrointestinal) was evaluated either clinically or biochemically with selected blood and urine parameters. Results: Acidemic and control groups were similar for pregnancy complications before labor, but acidemic infants were more often delivered by cesarean section (20/35 vs 6/35, p = 0.001). No differences existed between acidemic and control infants in gestational age, birth weight, neurologic evaluations, hearing deficits, feeding tolerance, and hepatic function. The acidemic group had a higher mean serum creatinine than control infants on day 2 of life (0.90 ± 0.34 vs 0.71 ± 0.12 mg/dl, p = 0.005) and a greater number of infants with a urine Chemstrip positive for heme (14/35 vs 3/35, p = 0.005). No differences existed between groups in time to first void, urine specific gravity, and number of infants with microscopic hematuria. Conclusion: Term and near-term infants born with an umbilical artery pH ≤ 7.0 and triaged to the newborn nursery on the basis of a stable appearance in the delivery room do not have clinical manifestations of hypoxia-ischemia in the 48 hours after birth. The higher mean serum creatinine for acidemic compared with control groups is presumably prerenal in origin and results from processes responsible for profound fetal acidemia. Infants with an umbilical artery pH ≤ 7.0 and assessed to be clinically well can be treated similar to nonacidemic infants.

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