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Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years

Zaigham, Mehreen LU ; Källén, Karin LU ; Maršál, Karel LU and Olofsson, Per LU (2019) In Acta Paediatrica, International Journal of Paediatrics 109(1). p.85-92
Abstract

Aim: It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes. Methods: We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22-26 weeks of gestation during 2004-2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age-related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (<10th percentile) and mortality and... (More)

Aim: It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes. Methods: We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22-26 weeks of gestation during 2004-2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age-related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (<10th percentile) and mortality and neurodevelopmental outcome were estimated. Results: Cord blood determination was more common in surviving infants (P <.001), with pH determined in 322/705 (46%) and base excess in 311/705 (44%). Extremely preterm infants had higher pH values than term infants (P <.0001), with no change from 22 to 26 weeks of gestation (P =.61, r2 =.001). Multiple logistic regression showed no association between low blood gas values and risk of death or neurodevelopmental impairment at 6.5 years (P ≥.17). Conclusion: Hypoxia with acidosis at birth was not associated with an increased risk of death or impaired neurodevelopmental in extremely preterm born children at 6.5 years.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
acidosis, extremely preterm infants, mortality, neurodevelopmental outcome, umbilical cord blood gases
in
Acta Paediatrica, International Journal of Paediatrics
volume
109
issue
1
pages
85 - 92
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:31265156
  • scopus:85070072005
ISSN
0803-5253
DOI
10.1111/apa.14925
language
English
LU publication?
yes
id
31ec1e60-bb5f-45fa-a4bb-d2838594d357
date added to LUP
2019-08-22 14:02:02
date last changed
2020-01-13 08:59:50
@article{31ec1e60-bb5f-45fa-a4bb-d2838594d357,
  abstract     = {<p>Aim: It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes. Methods: We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22-26 weeks of gestation during 2004-2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age-related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (&lt;10th percentile) and mortality and neurodevelopmental outcome were estimated. Results: Cord blood determination was more common in surviving infants (P &lt;.001), with pH determined in 322/705 (46%) and base excess in 311/705 (44%). Extremely preterm infants had higher pH values than term infants (P &lt;.0001), with no change from 22 to 26 weeks of gestation (P =.61, r<sup>2</sup> =.001). Multiple logistic regression showed no association between low blood gas values and risk of death or neurodevelopmental impairment at 6.5 years (P ≥.17). Conclusion: Hypoxia with acidosis at birth was not associated with an increased risk of death or impaired neurodevelopmental in extremely preterm born children at 6.5 years.</p>},
  author       = {Zaigham, Mehreen and Källén, Karin and Maršál, Karel and Olofsson, Per},
  issn         = {0803-5253},
  language     = {eng},
  month        = {07},
  number       = {1},
  pages        = {85--92},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Paediatrica, International Journal of Paediatrics},
  title        = {Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years},
  url          = {http://dx.doi.org/10.1111/apa.14925},
  doi          = {10.1111/apa.14925},
  volume       = {109},
  year         = {2019},
}