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Different types of acid-base changes at birth, fetal heart rate patterns, and infant outcome at 4 years of age

Herbst, Andreas LU ; Thorngren-Jerneck, Kristina LU ; Wu, Lianfang and Ingemarsson, Ingemar LU (1997) In Acta Obstetricia et Gynecologica Scandinavica 76(10). p.953-958
Abstract
BACKGROUND: To study the relationship between different types of acidemia in umbilical artery blood at birth, fetal heart rate (FHR) patterns during labor, and infant long-term outcome. METHODS: Case-control study of 48 infants with pure high base deficit (base deficit (BD) > or = 12 mmol/L and pCO2 < 8.0 kPa), 51 with mixed acidemia (BD > or = 12 mmol/L and pCO2 > or = 8.0 kPa), born at or after term, and controls matched for maternal age, parity, and gestational age at birth. FHR patterns during labor and the results of developmental screening at age 4 were compared between the groups. RESULTS: Late decelerations were associated with pure high base deficit and complicated variable decelerations with mixed acidemia. Both types... (More)
BACKGROUND: To study the relationship between different types of acidemia in umbilical artery blood at birth, fetal heart rate (FHR) patterns during labor, and infant long-term outcome. METHODS: Case-control study of 48 infants with pure high base deficit (base deficit (BD) > or = 12 mmol/L and pCO2 < 8.0 kPa), 51 with mixed acidemia (BD > or = 12 mmol/L and pCO2 > or = 8.0 kPa), born at or after term, and controls matched for maternal age, parity, and gestational age at birth. FHR patterns during labor and the results of developmental screening at age 4 were compared between the groups. RESULTS: Late decelerations were associated with pure high base deficit and complicated variable decelerations with mixed acidemia. Both types of acidemia were correlated with Apgar scores below 7 at 1 minute, and mixed acidemia with more admissions to the neonatal intensive care unit. Developmental screening at age 4 years showed no significant differences between infants with mixed acidemia or pure high base deficit and controls. Twelve infants with mixed acidemia and six controls had deficits in language/speech development. CONCLUSIONS: Late decelerations may be an indicator of a metabolic component of acidemia and complicated variable decelerations an indicator of mixed acidemia. The higher rate of admissions to the neonatal intensive care unit in cases with mixed acidemia may suggest that a concomitant hypercapnia (resulting in lower pH) in metabolic acidemia at birth may be of importance for the outcome. A possible relation between acidemia at birth and deficits in speech/language development should be further evaluated. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acidemia, fetal heart rate patterns, outcome
in
Acta Obstetricia et Gynecologica Scandinavica
volume
76
issue
10
pages
953 - 958
publisher
Wiley-Blackwell
external identifiers
  • pmid:9435735
  • scopus:0030727298
ISSN
1600-0412
DOI
10.3109/00016349709034908
language
English
LU publication?
yes
id
6fa1e151-0eba-42fc-a04a-3c7b1c6a6c2c (old id 1111464)
date added to LUP
2008-07-17 13:54:50
date last changed
2017-01-01 07:24:53
@article{6fa1e151-0eba-42fc-a04a-3c7b1c6a6c2c,
  abstract     = {BACKGROUND: To study the relationship between different types of acidemia in umbilical artery blood at birth, fetal heart rate (FHR) patterns during labor, and infant long-term outcome. METHODS: Case-control study of 48 infants with pure high base deficit (base deficit (BD) &gt; or = 12 mmol/L and pCO2 &lt; 8.0 kPa), 51 with mixed acidemia (BD &gt; or = 12 mmol/L and pCO2 &gt; or = 8.0 kPa), born at or after term, and controls matched for maternal age, parity, and gestational age at birth. FHR patterns during labor and the results of developmental screening at age 4 were compared between the groups. RESULTS: Late decelerations were associated with pure high base deficit and complicated variable decelerations with mixed acidemia. Both types of acidemia were correlated with Apgar scores below 7 at 1 minute, and mixed acidemia with more admissions to the neonatal intensive care unit. Developmental screening at age 4 years showed no significant differences between infants with mixed acidemia or pure high base deficit and controls. Twelve infants with mixed acidemia and six controls had deficits in language/speech development. CONCLUSIONS: Late decelerations may be an indicator of a metabolic component of acidemia and complicated variable decelerations an indicator of mixed acidemia. The higher rate of admissions to the neonatal intensive care unit in cases with mixed acidemia may suggest that a concomitant hypercapnia (resulting in lower pH) in metabolic acidemia at birth may be of importance for the outcome. A possible relation between acidemia at birth and deficits in speech/language development should be further evaluated.},
  author       = {Herbst, Andreas and Thorngren-Jerneck, Kristina and Wu, Lianfang and Ingemarsson, Ingemar},
  issn         = {1600-0412},
  keyword      = {acidemia,fetal heart rate patterns,outcome},
  language     = {eng},
  number       = {10},
  pages        = {953--958},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Different types of acid-base changes at birth, fetal heart rate patterns, and infant outcome at 4 years of age},
  url          = {http://dx.doi.org/10.3109/00016349709034908},
  volume       = {76},
  year         = {1997},
}