Neurologic Injury in Acidemic Term Infants

Alison G. Cahill, Amit M. Mathur, Christopher D. Smyser, Robert C. McKinstry, Kimberly A. Roehl, Julia D. López, Terrie E. Inder, George A. Macones

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective To determine whether arterial umbilical cord gas (aUCG) pH, in anatomically normal-term infants, could select infants at risk for brain injury identified on magnetic resonance imaging (MRI). Study Design We performed a nested case-control within a prospective cohort of 8,580 women. Cases, with an aUCG pH < 7.10, were temporally, age, and sex matched to controls with an aUCG pH ≥ 7.20. Bi- and multivariable analyses compared the presence and severity of brain injury. Secondary analyses estimated whether elevated arterial base excess or lactate were associated with brain injury. Results Fifty-five cases were matched to 165 controls. There was no statistical difference in brain injury between the groups (adjusted odds ratio [aOR]: 1.8, 95% confidence interval [CI]: 0.7-4.4]). Base excess ≥ -8 mEq/L was not significantly associated with brain injury (p = 0.12). There was no increase in risk of injury based on elevation of arterial lactate ≥ 4 mmol L (p = 1.00). Cases were significantly more likely to have an abnormal score in several domains of the Dubowitz neurologic examination. Conclusion The aUCG acid-base parameters alone are not sufficient clinical markers to identify term infants that might benefit from MRI of the brain to identify injury.

Original languageEnglish
Pages (from-to)668-675
Number of pages8
JournalAmerican journal of perinatology
Volume34
Issue number7
DOIs
StatePublished - Jun 1 2017

Keywords

  • academia
  • arterial umbilical cord gas pH
  • brain injury
  • magnetic resonance imaging

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