Base deficit estimation in umbilical cord blood is influenced by gestational age, choice of fetal fluid compartment, and algorithm for calculation.
(2006) In American Journal of Obstetrics and Gynecology 195(6). p.16511656 Abstract
 Objective: The purpose of this study was to explore the influences of gestational age, the choice of fetal fluid compartment, and the algorithm for calculation on the estimation of the base deficit in umbilical cord arterial blood Lit birth. Study design: From 1995 to 2002, cord arterial blood gases and obstetric data were available for 43,551 newborn infants at 37 + weeks of gestation (cohort 1). The mean base deficit in blood and the base deficit in extracellular fluid were estimated from pH and PCO2 values in 28,213 newborn infants with a 5minute Apgar score of >= 9 (cohort 11) with the use of 3 different calculation algorithms (base deficit in blood, base deficit in extracellular fluid [A], and base deficit in extracellular fluid... (More)
 Objective: The purpose of this study was to explore the influences of gestational age, the choice of fetal fluid compartment, and the algorithm for calculation on the estimation of the base deficit in umbilical cord arterial blood Lit birth. Study design: From 1995 to 2002, cord arterial blood gases and obstetric data were available for 43,551 newborn infants at 37 + weeks of gestation (cohort 1). The mean base deficit in blood and the base deficit in extracellular fluid were estimated from pH and PCO2 values in 28,213 newborn infants with a 5minute Apgar score of >= 9 (cohort 11) with the use of 3 different calculation algorithms (base deficit in blood, base deficit in extracellular fluid [A], and base deficit in extracellular fluid [B]). Results: In cohort 11, the base deficit in blood, the base deficit in extracellular fluid (A), and the base deficit in extracellular fluid (B) increased with advancing gestational age (linear regression, P < .0001). The curves run almost parallel, with the base deficit in blood being higher than the base deficit in extracellular fluid (A) and (B). With the use of receiver operating characteristic Curves in cohort 1, the area under curve to indicate a 5minute Apgar score of < 7 and < 4 showed the area under curvepH to be greater than the area under curvebase deficit in extracellular fluid (A) and (B), the area under curvebase deficit in blood to be greater than the area under Curvebase deficit in extracellular fluid (A) and (B) for a 5minute Apgar score of < 7, and the area under curvebase deficit in blood to be greater than the area under curvebase deficit in extracellular fluid (A) and (B) for an Apgar score of < 4. The cutoffs with highest sensitivity and lowest falsepositive rate for a 5minute Apgar score of < 7 and < 4 were, for both scores, a pH value of 7.15, a base deficit in blood of 10 mmol/L, a base deficit in extracellular fluid (A) of 8 mmol/L, and a base deficit in extracellular fluid (B) of 6 mmol/L. Conclusion: The calculated values of the base deficit in umbilical cord arterial blood are influenced decisively by gestational age, the choice of fetal fluid compartment, and the calculation algorithms that are used. The power of the base deficit to indicate neonatal distress depends on the choices of fluid compartment and the algorithm that is used to calculate the base deficit. (c) 2006 Mosby, Inc. All rights reserved. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/160840
 author
 Wiberg, Nana ^{LU} ; Källén, Karin ^{LU} and Olofsson, Per ^{LU}
 organization
 publishing date
 2006
 type
 Contribution to journal
 publication status
 published
 subject
 keywords
 fetal fluid, compartment, gestational age, pregnancy umbilical cord, blood gas, base excess, base deficit, acidosis
 in
 American Journal of Obstetrics and Gynecology
 volume
 195
 issue
 6
 pages
 1651  1656
 publisher
 Elsevier
 external identifiers

 wos:000242819400024
 scopus:33751240853
 ISSN
 10976868
 DOI
 10.1016/j.ajog.2006.05.043
 language
 English
 LU publication?
 yes
 id
 edde9f281d6e4f97af4803e7326a7cab (old id 160840)
 alternative location
 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16996464&dopt=Abstract
 date added to LUP
 20160401 12:25:41
 date last changed
 20200715 02:01:42
@article{edde9f281d6e4f97af4803e7326a7cab, abstract = {Objective: The purpose of this study was to explore the influences of gestational age, the choice of fetal fluid compartment, and the algorithm for calculation on the estimation of the base deficit in umbilical cord arterial blood Lit birth. Study design: From 1995 to 2002, cord arterial blood gases and obstetric data were available for 43,551 newborn infants at 37 + weeks of gestation (cohort 1). The mean base deficit in blood and the base deficit in extracellular fluid were estimated from pH and PCO2 values in 28,213 newborn infants with a 5minute Apgar score of >= 9 (cohort 11) with the use of 3 different calculation algorithms (base deficit in blood, base deficit in extracellular fluid [A], and base deficit in extracellular fluid [B]). Results: In cohort 11, the base deficit in blood, the base deficit in extracellular fluid (A), and the base deficit in extracellular fluid (B) increased with advancing gestational age (linear regression, P < .0001). The curves run almost parallel, with the base deficit in blood being higher than the base deficit in extracellular fluid (A) and (B). With the use of receiver operating characteristic Curves in cohort 1, the area under curve to indicate a 5minute Apgar score of < 7 and < 4 showed the area under curvepH to be greater than the area under curvebase deficit in extracellular fluid (A) and (B), the area under curvebase deficit in blood to be greater than the area under Curvebase deficit in extracellular fluid (A) and (B) for a 5minute Apgar score of < 7, and the area under curvebase deficit in blood to be greater than the area under curvebase deficit in extracellular fluid (A) and (B) for an Apgar score of < 4. The cutoffs with highest sensitivity and lowest falsepositive rate for a 5minute Apgar score of < 7 and < 4 were, for both scores, a pH value of 7.15, a base deficit in blood of 10 mmol/L, a base deficit in extracellular fluid (A) of 8 mmol/L, and a base deficit in extracellular fluid (B) of 6 mmol/L. Conclusion: The calculated values of the base deficit in umbilical cord arterial blood are influenced decisively by gestational age, the choice of fetal fluid compartment, and the calculation algorithms that are used. The power of the base deficit to indicate neonatal distress depends on the choices of fluid compartment and the algorithm that is used to calculate the base deficit. (c) 2006 Mosby, Inc. All rights reserved.}, author = {Wiberg, Nana and Källén, Karin and Olofsson, Per}, issn = {10976868}, language = {eng}, number = {6}, pages = {16511656}, publisher = {Elsevier}, series = {American Journal of Obstetrics and Gynecology}, title = {Base deficit estimation in umbilical cord blood is influenced by gestational age, choice of fetal fluid compartment, and algorithm for calculation.}, url = {http://dx.doi.org/10.1016/j.ajog.2006.05.043}, doi = {10.1016/j.ajog.2006.05.043}, volume = {195}, year = {2006}, }