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Association between umbilical cord artery pCO2and the Apgar score; elevated levels of pCO2may be beneficial for neonatal vitality after moderate acidemia
| Content Provider | Scilit |
|---|---|
| Author | Kro, Grete A. B. Yli, Branka M. Rasmussen, Svein Norèn, Håkan Amer-Wåhlin, Isis Rosén, Karl G. Stray-Pedersen, Babill Saugstad, Ola D. |
| Copyright Year | 2013 |
| Description | Journal: Acta Obstetricia et Gynecologica Scandinavica Objective To determine the association between 5‐min Apgar score and umbilical cord artery carbon dioxide tension $(pCO_{2}$). Design Observational study. Setting European hospital labor wards. Population Data from 36 432 newborns ≥36 gestational weeks were obtained from three sources: two trials of monitoring with fetal electrocardiogram (the Swedish randomized controlled trial and the European Union Fetal ECG trial) and Mölndal Hospital data. After validation of the acid–base values, 25 806 5‐min Apgar scores were available for analysis. Methods Validation of the umbilical cord acid–base values was performed to obtain reliable data. 5‐min Apgar score was regressed against cord artery $pCO_{2}$ in a polynomial multilevel model. Main outcome measures Five‐min Apgar score, umbilical cord $pCO_{2}$, pH, and base deficit. Results Overall, a higher cord artery $pCO_{2}$ was found to be associated with lower 5‐min Apgar scores. However, among newborns with moderate acidemia, lower umbilical cord artery $pCO_{2}$ (≤median $pCO_{2}$ for the specific cord artery pH) was associated with lower 5‐min Apgar scores, with a relative risk of 2.0 (95% confidence interval: 1.4–2.8) for 5‐min Apgar scores 0–6. Conclusions Metabolic acidosis affects the newborn's vitality more than respiratory acidosis. In addition, elevated levels of $pCO_{2}$ may be beneficial for fetuses with moderate acidemia, and thus cord artery $pCO_{2}$ is a factor that should be considered when assessing the compromised newborn. |
| Ending Page | 670 |
| Starting Page | 662 |
| ISSN | 00221295 |
| e-ISSN | 16000412 |
| DOI | 10.1111/aogs.12090 |
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Issue Number | 6 |
| Volume Number | 92 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2013-03-29 |
| Access Restriction | Open |
| Subject Keyword | Journal: Acta Obstetricia et Gynecologica Scandinavica Obstetrics and Gynecology Acid–base Balance Apgar Score Intrapartum Hypoxia Umbilical Cord Artery Pco2 |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
