Neonatal complications in newborns with an umbilical artery pH<7.00

OBJECTIVE: Our purpose was to determine the significance of an umbilical artery pH <7.00 in relation to neonatal morbidity and mortality. STUDY DESIGN: Between 1986 and 1993 acid-base assessment of the umbilical artery was performed routinely in 10,699 deliveries. In a retrospective cohort study 84 nonanomalous neonates with an umbilical artery pH <7.00 were individually matched with 84 neonates with an umbilical artery pH >7.24. Matched variables included year of delivery, gender, parity, maternal age, delivery mode, fetal presentation, gestational age, and birth weight. Differences in morbidity between the two groups during the neonatal period (until 28 days after delivery) were investigated. RESULTS: Neonates with an umbilical artery pH <7.00 versus >7.24 showed significant differences in the following: neonatal condition directly post partum; neurologic, respiratory, cardiovascular, and gastrointestinal complications; and neonatal intensive care unit admissions. No significance was found in renal dysfunction and mortality rate. The proportion of premature infants (<37 weeks) was 17% in both groups. In the acidotic group a 1-minute Apgar score less than or equal to 3 and a 5-minute Apgar score <7 was predictive for neonatal complications. CONCLUSIONS: Severe intrapartum asphyxia, quantified by an umbilical artery pH <7.00, poses a threat to the neonate's health.