Umbilical Cord Arterial Blood Gas and Apgar Score: Who Is at Higher Risk?

Document Type: Original Article

Authors

1 Department of Obstetrics and Gynecology, Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Obstetrics and Gynecology, Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran

3 Children’s and Neonatal Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Children’s and Neonatal Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran

Abstract

Background: Fetal asphyxia and the consequent neurological damages could be avoided if the risk factors are controlled at earlier stages. Umbilical cord arterial blood gas (UCABG) seems to be related to the Apgar scores, as well as the neonatal morbidity and mortality rates. Therefore, we designed this study to assess the correlation between the Apgar score and UCABG in Northeast of Iran.
Methods: This case-control study evaluated 438 term newborns and 62 preterm infants born during 2012-2013. Peripartum asphyxia, admission in the neonatal intensive care unit, and death were recorded as outcome measures. All the data were analyzed using the t-test and logistic regression analysis.
Results: Mild to moderate acidemia (pH=7-7.2) was reported in 9.6% and severe acidemia (PH<7) was observed in 1% of the participants. Multivariate analysis showed that aspiration of amniotic fluid, umbilical cord pH ≤ 7.2, umbilical cord base excess, and being preterm could be considered as the predictors of lower first-minute Apgar score.
Conclusion: Umbilical cord blood gas measurement is a useful tool to detect the neonates who are at higher risk of low Apgar.

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