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Association of umbilical cord venoarterial differences, ΔpH, to morbidity and mortality up to twenty years of follow-up

Sundberg, Tiia-Marie LU orcid ; Källén, Karin LU and Zaigham, Mehreen LU orcid (2025) In European Journal of Obstetrics, Gynecology, and Reproductive Biology 313(Suppl 1). p.93-93
Abstract (Swedish)
Introduction/Background: Measurement of umbilical cord blood gases
at birth is the gold standard of capturing the metabolic state of the newborn. Dual sampling of umbilical cord vessels is mandatory, yet the longterm predictive value of venoarterial differences, ΔpH, remain undetermined. Previously, large ΔpH showed a protective effect against adverse
neonatal outcomes.
Objectives: To investigate the association of ΔpH and long-term morbidity and mortality, up to 20 years after birth.
Methods: This was a retrospective study of singleton births with cephalic presentation born 1997–2012 at Skåne University hospital in Malmö,
Sweden. Umbilical cord blood records were validated and crosslinked to
the Swedish Medical... (More)
Introduction/Background: Measurement of umbilical cord blood gases
at birth is the gold standard of capturing the metabolic state of the newborn. Dual sampling of umbilical cord vessels is mandatory, yet the longterm predictive value of venoarterial differences, ΔpH, remain undetermined. Previously, large ΔpH showed a protective effect against adverse
neonatal outcomes.
Objectives: To investigate the association of ΔpH and long-term morbidity and mortality, up to 20 years after birth.
Methods: This was a retrospective study of singleton births with cephalic presentation born 1997–2012 at Skåne University hospital in Malmö,
Sweden. Umbilical cord blood records were validated and crosslinked to
the Swedish Medical Birth Register, Patient Register and the Cause of
Death Register. Hazard ratios for diagnosis, according to the International Classification of Disease 10, were estimated for the ≤ 10th/
10th–90th/≥90th percentiles of ΔpH. Hazard ratios were adjusted for
maternal age, smoking, body mass index, parity and gestational age.
Results/Discussion: The study population was comprised of 35,171
births, of which 4,956 had small ΔpH (≤0.04), 26,690 normal ΔpH
(0.04–0.150) and 3,525 large ΔpH (≥0.150). Cohort characteristics showed
that large for gestational age birth weight was associated with large ΔpH
(3.6%/4.1%/6.7%), and small for gestational age was associated with small
ΔpH (4.9%/2.9%/1.3%). Emergency cesarean section was associated with
small ΔpH (21.5%/7.4%/2.0%), vacuum extraction/forceps was associated
with large ΔpH (6.0%/6.8%/11.5%). Hazard ratios showed no significant
association with either small or large ΔpH for any organ related disease,
including mental or behavioral disorders.
Conclusion: Using a large cohort of strictly validated umbilical cord
blood gases, we found that abnormal ΔpH showed no significant association of increased risk of organ-related morbidity or mortality up to 20-
years of age of follow-up. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Obstetrics, Gynecology, and Reproductive Biology
volume
313
issue
Suppl 1
article number
114222
pages
93 - 93
publisher
Elsevier
ISSN
0301-2115
DOI
10.1016/j.ejogrb.2025.114222
project
Use of Umbilical Cord Blood Gases in Determining Mortality and Morbidity after Birth Asphyxia
language
Swedish
LU publication?
yes
id
0259a121-97e5-454a-aaf2-ac586a92d581
date added to LUP
2026-02-27 10:53:28
date last changed
2026-02-27 13:08:31
@misc{0259a121-97e5-454a-aaf2-ac586a92d581,
  abstract     = {{Introduction/Background: Measurement of umbilical cord blood gases<br/>at birth is the gold standard of capturing the metabolic state of the newborn. Dual sampling of umbilical cord vessels is mandatory, yet the longterm predictive value of venoarterial differences, ΔpH, remain undetermined. Previously, large ΔpH showed a protective effect against adverse<br/>neonatal outcomes.<br/>Objectives: To investigate the association of ΔpH and long-term morbidity and mortality, up to 20 years after birth.<br/>Methods: This was a retrospective study of singleton births with cephalic presentation born 1997–2012 at Skåne University hospital in Malmö,<br/>Sweden. Umbilical cord blood records were validated and crosslinked to<br/>the Swedish Medical Birth Register, Patient Register and the Cause of<br/>Death Register. Hazard ratios for diagnosis, according to the International Classification of Disease 10, were estimated for the ≤ 10th/<br/>10th–90th/≥90th percentiles of ΔpH. Hazard ratios were adjusted for<br/>maternal age, smoking, body mass index, parity and gestational age.<br/>Results/Discussion: The study population was comprised of 35,171<br/>births, of which 4,956 had small ΔpH (≤0.04), 26,690 normal ΔpH<br/>(0.04–0.150) and 3,525 large ΔpH (≥0.150). Cohort characteristics showed<br/>that large for gestational age birth weight was associated with large ΔpH<br/>(3.6%/4.1%/6.7%), and small for gestational age was associated with small<br/>ΔpH (4.9%/2.9%/1.3%). Emergency cesarean section was associated with<br/>small ΔpH (21.5%/7.4%/2.0%), vacuum extraction/forceps was associated<br/>with large ΔpH (6.0%/6.8%/11.5%). Hazard ratios showed no significant<br/>association with either small or large ΔpH for any organ related disease,<br/>including mental or behavioral disorders.<br/>Conclusion: Using a large cohort of strictly validated umbilical cord<br/>blood gases, we found that abnormal ΔpH showed no significant association of increased risk of organ-related morbidity or mortality up to 20-<br/>years of age of follow-up.}},
  author       = {{Sundberg, Tiia-Marie and Källén, Karin and Zaigham, Mehreen}},
  issn         = {{0301-2115}},
  language     = {{swe}},
  month        = {{09}},
  note         = {{Conference Abstract}},
  number       = {{Suppl 1}},
  pages        = {{93--93}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Obstetrics, Gynecology, and Reproductive Biology}},
  title        = {{Association of umbilical cord venoarterial differences, ΔpH, to morbidity and mortality up to twenty years of follow-up}},
  url          = {{http://dx.doi.org/10.1016/j.ejogrb.2025.114222}},
  doi          = {{10.1016/j.ejogrb.2025.114222}},
  volume       = {{313}},
  year         = {{2025}},
}