Follow-up of children born with an umbilical arterial blood pH<7

OBJECTIVE: We performed neurodevelopmental assessment in children born with an umbilical artery pH <7. STUDY DESIGN: All infants born with an umbilical artery pH <7 from a 19-month period were retrieved from the obstetric database. Obstetric, neonatal, and pediatric records were reviewed. At an age of 1 to 3 years, children were visited at home for semi-structured questioning of the mother and a Denver Developmental Screening Test of the child. RESULTS: During the study period 1614 umbilical artery pH measurements were entered in the database. Thirty (1.9%) were <7. From this group 23 infants were admitted to the neonatal intensive care unit, and 8 of them required intubation. Twenty-eight children survived the neonatal period. Three children experienced an episode of mild hypertonia. One child had a mild motor developmental delay. CONCLUSION: Babies born with an umbilical artery pH <7 are at great risk to experience considerable short-term morbidity. Those who leave the neonatal intensive care unit without major problems have good outcomes, and pessimism in counseling their parents is unwarranted.