Risk factors for acidemia at birth
Abstract
OBJECTIVE: To identify risk factors for acidemia at birth. METHODS: From September 1988 to December 1996, cord arterial blood pH was measured in 23,016 of 27,064 live-born infants (85.0%). Values below 7.05 were observed in 264 newborns (1.1%), of whom 14 born by cesarean delivery before labor and one triplet infant were excluded from the study. The remaining 249 newborns with acidemia and their mothers were compared with 249 unmatched controls with normal pH (the first infant with umbilical arterial pH above 7.10 born after each case). Multivariate logistic regression was used to adjust for potentially confounding variables. RESULTS: Variables significantly and independently associated with acidemia at birth were labor with breech presentation (adjusted odds ratio [OR]2.9), oxytocin administration (OR 2.1), meperidine administration (OR 2.0), cord entanglement (OR 1.7), and male gender of the infant (OR 1.4). Clinical evidence of chorioamnionitis also was associated with acidemia, although after adjustment for prematurity, the association was not statistically significant (OR 3.9, 95% confidence interval 0.8, 19). CONCLUSION: Labor with breech presentation, administration of oxytocin and meperidine, cord entanglement, and male gender are associated with an increased risk for insufficient fetomaternal gas exchange.
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From numerous studies of different eras and sizes, it can firmly be concluded that in the cord artery, the statistically defined lower pH limit (mean -2 standard deviations) is 7.10.
“From numerous studies of different eras and sizes, it can firmly be concluded that in the cord artery, the statistically defined lower pH limit (mean -2 standard deviations) is 7.10.”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [44]
From these studies, there is robust evidence that the statistically defined limit for cord artery acidemia after labor with uterine contractions is a pH of 7.10 when the definition of mean -2 SD is used.
“From these and the other studies mentioned, from different eras and of different sizes and quality, there is thus robust evidence that the statistically defined limit for cord artery acidemia after labor with uterine contractions is a pH of 7.10 in the cord artery when the definition of mean À2 SD is used.”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [44]
In a study of 23,016 births from Skåne University Hospital, the mean arterial pH was 7.28 and the mean -2 SD limit was 7.10.
“In a study of 23,016 births from our hospital, the Skåne University Hospital (Malmö and Lund, Sweden), where cord pH measurements have been routine since 1981, the mean arterial pH was 7.28 and the mean À2 SD limit was 7.10.44”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [44]
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Olofsson, P. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.07.001 · Cited by 104 · see citing works
- Authors
- HERBST, A., WOLNERHANSSEN, P., & INGEMARSSON, I.
- Affiliations
- Lund University (SE)
- Corresponding author
- HERBST, A
- ORCID
- HERBST, A
- Venue
- Obstetrics & Gynecology
- Published
- 1997-07
- Volume
- 90
- Issue
- 1
- Pages
- 125-130
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2121000166
- Cited by
- 72
- References
- 17
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 6
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- risk factors, breech presentation, oxytocin administration, pethidine, cord entanglement, chorioamnionitis, male infants, labor
- MeSH terms
- Female, Fetal Blood, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Male, Metabolic Diseases, Risk Factors, Confidence Intervals, Odds Ratio
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