Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome
Abstract Objective To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Methods This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics an...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
2018-12-01
|
| Series: | Revista Brasileira de Ginecologia e Obstetrícia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018001200740&tlng=en |
| _version_ | 1798020753160929280 |
|---|---|
| author | Cátia Sofia Ferreira Ângela Melo Ana Helena Fachada Helena Solheiro Nuno Nogueira Martins |
| author_facet | Cátia Sofia Ferreira Ângela Melo Ana Helena Fachada Helena Solheiro Nuno Nogueira Martins |
| author_sort | Cátia Sofia Ferreira |
| collection | DOAJ |
| description | Abstract Objective To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Methods This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics and gynecology of Centro Hospitalar Tondela Viseu between September 2013 and September 2015. Total cohort and subgroup analysis were performed: group A-women with umbilical cord blood gas analysis (UCBGA) performed for non-reassuring fetal cardiotocographic patterns, placental abruption, or shoulder dystocia; and group B-all the others. Assays were made with the software SPSS for Windows, Versions 20.0 and 21.0 (IBM Corp., Armonk, NY, USA). Results A total of 428 UCBGAs met the inclusion criteria. The group analysis revealed an association between group A and pHua ≤7.00, as well as between BDua ≥12.00 mmol/L and 1st minute Apgar score ≤4 (p = 0.011). After the application of the logistic regression models in the total cohort analysis, pHua ≤7.00 had an impact in the occurrence of acute neonatal hypoxia (odds ratio [OR]: 6.71; 95% confidence interval [CI]: 1.21-37.06; p = 0.029); multiparous women had a higher risk of delivering a newborn with first minute Apgar score ≤4 and acute neonatal hypoxia (OR: 5.38; 95% CI: 1.35-21.43; p = 0.017; and OR: 2.66; 95% CI: 1.03-6.89, p = 0.043, respectively); women who had urologic problems during pregnancy had a higher risk of delivering a newborn with 5th minute Apgar score ≤7 (OR: 15.17; 95% CI: 1.29-177.99; p = 0.030); and shoulder dystocia represented a 15 times higher risk of acute neonatal hypoxia (OR: 14.82; 95% CI: 2.20-99.60; p = 0.006). Conclusion The pHua and the BDua are predictors of adverse neonatal outcome, and UCBGA is a useful tool for screening newborns at risk. Universal UCBGA should be considered for all deliveries, as it is an accurate screening test for neonatal hypoxia. |
| first_indexed | 2024-04-11T17:02:46Z |
| format | Article |
| id | doaj.art-985567d9621a4e6b84690b545769638d |
| institution | Directory Open Access Journal |
| issn | 0100-7203 |
| language | English |
| last_indexed | 2024-04-11T17:02:46Z |
| publishDate | 2018-12-01 |
| publisher | Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
| record_format | Article |
| series | Revista Brasileira de Ginecologia e Obstetrícia |
| spelling | doaj.art-985567d9621a4e6b84690b545769638d2022-12-22T04:13:07ZengFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia0100-72032018-12-01401274074810.1055/s-0038-1675187Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal OutcomeCátia Sofia FerreiraÂngela MeloAna Helena FachadaHelena SolheiroNuno Nogueira MartinsAbstract Objective To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Methods This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics and gynecology of Centro Hospitalar Tondela Viseu between September 2013 and September 2015. Total cohort and subgroup analysis were performed: group A-women with umbilical cord blood gas analysis (UCBGA) performed for non-reassuring fetal cardiotocographic patterns, placental abruption, or shoulder dystocia; and group B-all the others. Assays were made with the software SPSS for Windows, Versions 20.0 and 21.0 (IBM Corp., Armonk, NY, USA). Results A total of 428 UCBGAs met the inclusion criteria. The group analysis revealed an association between group A and pHua ≤7.00, as well as between BDua ≥12.00 mmol/L and 1st minute Apgar score ≤4 (p = 0.011). After the application of the logistic regression models in the total cohort analysis, pHua ≤7.00 had an impact in the occurrence of acute neonatal hypoxia (odds ratio [OR]: 6.71; 95% confidence interval [CI]: 1.21-37.06; p = 0.029); multiparous women had a higher risk of delivering a newborn with first minute Apgar score ≤4 and acute neonatal hypoxia (OR: 5.38; 95% CI: 1.35-21.43; p = 0.017; and OR: 2.66; 95% CI: 1.03-6.89, p = 0.043, respectively); women who had urologic problems during pregnancy had a higher risk of delivering a newborn with 5th minute Apgar score ≤7 (OR: 15.17; 95% CI: 1.29-177.99; p = 0.030); and shoulder dystocia represented a 15 times higher risk of acute neonatal hypoxia (OR: 14.82; 95% CI: 2.20-99.60; p = 0.006). Conclusion The pHua and the BDua are predictors of adverse neonatal outcome, and UCBGA is a useful tool for screening newborns at risk. Universal UCBGA should be considered for all deliveries, as it is an accurate screening test for neonatal hypoxia.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018001200740&tlng=enUmbilical Cord Blood Gas Analysisdeliverymorbidityneonatology |
| spellingShingle | Cátia Sofia Ferreira Ângela Melo Ana Helena Fachada Helena Solheiro Nuno Nogueira Martins Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome Revista Brasileira de Ginecologia e Obstetrícia Umbilical Cord Blood Gas Analysis delivery morbidity neonatology |
| title | Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome |
| title_full | Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome |
| title_fullStr | Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome |
| title_full_unstemmed | Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome |
| title_short | Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome |
| title_sort | umbilical cord blood gas analysis obstetric performance and perinatal outcome |
| topic | Umbilical Cord Blood Gas Analysis delivery morbidity neonatology |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018001200740&tlng=en |
| work_keys_str_mv | AT catiasofiaferreira umbilicalcordbloodgasanalysisobstetricperformanceandperinataloutcome AT angelamelo umbilicalcordbloodgasanalysisobstetricperformanceandperinataloutcome AT anahelenafachada umbilicalcordbloodgasanalysisobstetricperformanceandperinataloutcome AT helenasolheiro umbilicalcordbloodgasanalysisobstetricperformanceandperinataloutcome AT nunonogueiramartins umbilicalcordbloodgasanalysisobstetricperformanceandperinataloutcome |