Perinatal Outcomes according to the Types of Fetal Acidosis in Term Newborns with Umbilical Artery Acidosis

Park, In Yang; Kwon, Ji Young; We, Ji Sun; Shin, Jae Eun; Shin, Jong Chul

Abstract

PURPOSE:To investigate the significance of umbilical artery acidosis and compare perinatal outcomes according to the types of acidosis for a tertiary hospital population delivered at term.
METHODS
We reviewed maternal and neonatal medical records of all term liveborn infants with an umbilical artery pH<7.25 who were delivered at our university-based center for three years. Two hundred seventy two study population were grouped into respiratory (N=137), metabolic (N=103), and mixed (N=32) acidosis. Pregnancy complications and perinatal outcomes were analyzed using student T test and chi square test.
RESULTS
The mean umbilical artery pH values of respiratory, metabolic, and mixed acidosis were 7.20+/-.05, 7.16+/-.90, and 7.07+/-.10, respectively. Neonates with pathologic fetal acidemia were more frequent in mixed acidosis and less frequent in respiratory acidosis (P<0.001). However, there were no significant differences in 1min and 5min Apgar scores. The cases with multiple nuchal cords were significantly common in mixed acidosis (P=0.021) and oligohydroamnios was higher in the metabolic acidosis (P=0.037). While the high base deficit (> or =20 mEq/L) and high pCO2 (> or =20 mmHg) were significantly associated with low pH value, the perinatal outcomes were not significantly different according to the level of base deficit or pCO2.
CONCLUSION
The mixed acidemia was more associated with pathologic fetal acidemia than pure respiratory or metabolic acidosis. The ability to predict not only metabolic but also respiratory component of fetal acidemia may help in safe management of delivery leading to reduce the fetal acidemia.