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Cited by 316Neonatal and fetal brain pathologyRenal function and acid-base balanceMaternal and Perinatal Health Interventions

Threshold of metabolic acidosis associated with newborn complications

Low, James A., Lindsay, Brian G., Derrick, E.Jane·1997·American Journal of Obstetrics and Gynecology
DOI 10.1016/s0002-9378(97)70080-2
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Abstract

Objective Our purpose was to determine the threshold of metabolic acidosis at delivery associated with newborn complications.Study design This study was a matched case-control study of 174 term newborn infants. Three groups defined by umbilical artery base deficit at birth were 4 to 8 mmol/L, 8 to 12 mmol/L, and 12 to 16 mmol/L. Newborn complications during the 5 days after birth were documented. A composite complication score defined the magnitude of all complications in each neonate.Results Moderate and severe newborn encephalopathy and respiratory complications and composite complication scores >3 were increased in the group with an umbilical artery base deficit of 12 to 16 mmol/L. Moderate or severe newborn complications occurred in 10% of newborns in the same group, whereas such complications occur in 40% of neonates with an umbilical artery base deficit >16 mmol/L at birth.Conclusion The threshold of fetal metabolic acidosis at delivery when moderate or severe newborn complications may occur is in an umbilical artery base deficit of 12 mmol/L. Thereafter, increasing metabolic acidosis is associated with a progression of severity of newborn complications.

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  • Base deficit values differing between analyzers could influence the diagnosis of metabolic acidosis, commonly defined as pH <7.00 combined with base deficit ≥12.0 mmol/L in umbilical cord arterial blood.

    “This could influence the diagnosis of metabolic acidosis, which is commonly defined as a pH <7.00 combined with a base deficit !12.0 mmol/L in umbilical cord arterial blood.”

    From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [33]

  • Low, ACOG, and several other organizations failed to mention from which fetal compartment (blood or ecf) their BD calculations stem, and the difference between BD blood and BD ecf, or between different BD blood equations, could be up to 2 mmol/L and decisive for diagnosing neonatal metabolic acidosis.

    “However, Low as well as ACOG and several other organizations failed to mention from which fetal compartment (blood or ecf) their BD calculations stem.”

    From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [33]

  • Low et al concluded that the threshold for metabolic acidosis associated with moderate or severe neonatal complications is 12.0 mmol/L.

    “Low et al 33 have concluded that the threshold for metabolic acidosis associated with moderate or severe neonatal complications is 12.0 mmol/L.”

    From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [33]

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Authors
Low, J. A., Lindsay, B. G., & Derrick, E. J.
Affiliations
Queen's University (CA)
ORCID
Low, James A.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
1997-12
Volume
177
Issue
6
Pages
1391-1394
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/s0002-9378(97)70080-2
OpenAlex
W2128825565
Cited by
316
References
18
Citations by year
2026: 9 · 2025: 5 · 2024: 14 · 2023: 15 · 2022: 16 · 2021: 11 · 2020: 10 · 2019: 13 · 2018: 18 · 2017: 12 · 2016: 15 · 2015: 12 · 2014: 14 · 2013: 20 · 2012: 14
FWCI
4.75
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
  • Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
neonatal complications, neonatal encephalopathy, neonatal respiratory complications, term infants
MeSH terms
Acidosis, Differential Threshold, Female, Fetus, Humans, Infant, Newborn, Infant, Newborn, Diseases, Obstetric Labor Complications, Pregnancy, Pregnancy Complications, Umbilical Arteries, Incidence, Case-Control Studies, Delivery, Obstetric

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