Impact of metabolic acidemia at birth on neonatal outcomes in infants born before 34 weeks’ gestation

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Abstract

Purpose: To examine prematurity-associated neonatal outcomes in early preterm infants with metabolic acidemia compared to those without such acidemia. Methods: We performed a retrospective cohort analysis to assess the impact of metabolic acidemia on prematurity-associated complications in a large cohort of singleton live-born infants with complete umbilical cord gas analyses delivered between 24 0/7 and 33 6/7 weeks. Metabolic acidemia was defined as an umbilical artery pH less than 7.0 plus a base deficit of 12 mmol/L or greater. Outcomes were adjusted for gestational age using logistic regression. Results: Between 1 January 1988 and 31 December 2014, 6970 singleton early preterm infants were delivered at our hospital, of which 126 (1.8%) had metabolic acidemia. Neonatal mortality as well as prematurity-associated morbidities were significantly increased in the presence of metabolic acidemia. Included were ventilator requirement (73% versus 36%, p < 0.001), grade 3/4 intraventricular hemorrhage (10% versus 4%, p < 0.001), periventricular leukomalacia (5% versus 2%, p = 0.036), and neonatal death (13% versus 4%, p < 0.001). These significant findings persisted after adjustment for gestational age. Conclusion: Metabolic acidemia significantly increases the risks related to prematurity in infants delivered prior to 34 weeks’ gestation.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
DOIs
StateAccepted/In press - Sep 21 2016

Fingerprint

Premature Infants
Parturition
Pregnancy
Gestational Age
Periventricular Leukomalacia
Umbilical Arteries
Umbilical Cord
Infant Mortality
Mechanical Ventilators
Cohort Studies
Gases
Logistic Models
Hemorrhage
Morbidity

Keywords

  • early preterm birth
  • Metabolic acidemia
  • prematurity-associated morbidity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

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title = "Impact of metabolic acidemia at birth on neonatal outcomes in infants born before 34 weeks’ gestation",
abstract = "Purpose: To examine prematurity-associated neonatal outcomes in early preterm infants with metabolic acidemia compared to those without such acidemia. Methods: We performed a retrospective cohort analysis to assess the impact of metabolic acidemia on prematurity-associated complications in a large cohort of singleton live-born infants with complete umbilical cord gas analyses delivered between 24 0/7 and 33 6/7 weeks. Metabolic acidemia was defined as an umbilical artery pH less than 7.0 plus a base deficit of 12 mmol/L or greater. Outcomes were adjusted for gestational age using logistic regression. Results: Between 1 January 1988 and 31 December 2014, 6970 singleton early preterm infants were delivered at our hospital, of which 126 (1.8{\%}) had metabolic acidemia. Neonatal mortality as well as prematurity-associated morbidities were significantly increased in the presence of metabolic acidemia. Included were ventilator requirement (73{\%} versus 36{\%}, p < 0.001), grade 3/4 intraventricular hemorrhage (10{\%} versus 4{\%}, p < 0.001), periventricular leukomalacia (5{\%} versus 2{\%}, p = 0.036), and neonatal death (13{\%} versus 4{\%}, p < 0.001). These significant findings persisted after adjustment for gestational age. Conclusion: Metabolic acidemia significantly increases the risks related to prematurity in infants delivered prior to 34 weeks’ gestation.",
keywords = "early preterm birth, Metabolic acidemia, prematurity-associated morbidity",
author = "Morgan, {Jamie L.} and Nelson, {David B.} and Casey, {Brian M.} and Bloom, {Steven L.} and McIntire, {Donald D.} and Leveno, {Kenneth J.}",
year = "2016",
month = "9",
day = "21",
doi = "10.1080/14767058.2016.1229767",
language = "English (US)",
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journal = "Journal of Maternal-Fetal and Neonatal Medicine",
issn = "1476-7058",
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TY - JOUR

T1 - Impact of metabolic acidemia at birth on neonatal outcomes in infants born before 34 weeks’ gestation

AU - Morgan, Jamie L.

AU - Nelson, David B.

AU - Casey, Brian M.

AU - Bloom, Steven L.

AU - McIntire, Donald D.

AU - Leveno, Kenneth J.

PY - 2016/9/21

Y1 - 2016/9/21

N2 - Purpose: To examine prematurity-associated neonatal outcomes in early preterm infants with metabolic acidemia compared to those without such acidemia. Methods: We performed a retrospective cohort analysis to assess the impact of metabolic acidemia on prematurity-associated complications in a large cohort of singleton live-born infants with complete umbilical cord gas analyses delivered between 24 0/7 and 33 6/7 weeks. Metabolic acidemia was defined as an umbilical artery pH less than 7.0 plus a base deficit of 12 mmol/L or greater. Outcomes were adjusted for gestational age using logistic regression. Results: Between 1 January 1988 and 31 December 2014, 6970 singleton early preterm infants were delivered at our hospital, of which 126 (1.8%) had metabolic acidemia. Neonatal mortality as well as prematurity-associated morbidities were significantly increased in the presence of metabolic acidemia. Included were ventilator requirement (73% versus 36%, p < 0.001), grade 3/4 intraventricular hemorrhage (10% versus 4%, p < 0.001), periventricular leukomalacia (5% versus 2%, p = 0.036), and neonatal death (13% versus 4%, p < 0.001). These significant findings persisted after adjustment for gestational age. Conclusion: Metabolic acidemia significantly increases the risks related to prematurity in infants delivered prior to 34 weeks’ gestation.

AB - Purpose: To examine prematurity-associated neonatal outcomes in early preterm infants with metabolic acidemia compared to those without such acidemia. Methods: We performed a retrospective cohort analysis to assess the impact of metabolic acidemia on prematurity-associated complications in a large cohort of singleton live-born infants with complete umbilical cord gas analyses delivered between 24 0/7 and 33 6/7 weeks. Metabolic acidemia was defined as an umbilical artery pH less than 7.0 plus a base deficit of 12 mmol/L or greater. Outcomes were adjusted for gestational age using logistic regression. Results: Between 1 January 1988 and 31 December 2014, 6970 singleton early preterm infants were delivered at our hospital, of which 126 (1.8%) had metabolic acidemia. Neonatal mortality as well as prematurity-associated morbidities were significantly increased in the presence of metabolic acidemia. Included were ventilator requirement (73% versus 36%, p < 0.001), grade 3/4 intraventricular hemorrhage (10% versus 4%, p < 0.001), periventricular leukomalacia (5% versus 2%, p = 0.036), and neonatal death (13% versus 4%, p < 0.001). These significant findings persisted after adjustment for gestational age. Conclusion: Metabolic acidemia significantly increases the risks related to prematurity in infants delivered prior to 34 weeks’ gestation.

KW - early preterm birth

KW - Metabolic acidemia

KW - prematurity-associated morbidity

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