Assessment of the Value of the Umbilical Cord Blood Gas Parameter as Indicator of the Neonatal Condition

Lee, Jeong Min; Shin, Hoon Bum; Choi, Young Bae; Lee, Na Mi; Yi, Dae Yong; Yun, Sin Weon; Chae, Soo Ahn; Lim, In Seok

Abstract

OBJECTIVE
Umbilical cord blood gas analysis has widely been used to objectively evaluate the medical condition of newborn. Because umbilical cord blood gas analysis enables an immediate assessment of the acid-base balance of the newborn, it is crucial to perform the umbilical cord blood gas analysis before arterial blood gas analysis has been performed. This study was designed to evaluate the umbilical cord pH as an indicator reflecting the general condition of the newborn and to analyze its correlation with Apgar score and newborn arterial blood gas analysis.
METHODS
A retrospective study was conducted for 209 neonates born from January 2013 to December 2015 at Chung-Ang University Medical Center. Demographic data such as Apgar score, gestational age, birth weight, umbilical cord blood analysis, newborn arterial blood gas analysis, and need for resuscitation were collected retrospectively.
RESULTS
In neonates with birth weight more than 2,500 g, Pearson correlation coefficient indicated there were statistically significant associations between 1-minute or 5-minute Apgar score and umbilical artery pH (r=0.35 and r=0.33 with P < 0.05, respectively). Similar correlations were also noted in those with a gestational age of more than 37 weeks (r=0.45 and r=0.44 with P < 0.05, respectively). In addition, the odd ratio of developing neonatal acidosis was much higher with neonates not resuscitated than those resuscitated (9.5 for pH, 19.5 for base excess).
CONCLUSION
Our study highlights the value of the umbilical artery pH and base excess as indicators of the neonatal condition.