Abstract:
OBJECTIVE:The purpose of this study was to investigate the significance of preterm acidosis and its risk factors. STUDY DESIGN:From a cohort of 786 consecutive singleton neonates who were born after spontaneous or iatrogenic preterm delivery at 24.0-33.6 weeks of gestation from January 1993 to December 2005 with an evaluation of umbilical artery pH at delivery, we extracted demographic, obstetric, neonatal, and placental histologic variables and related them to umbilical artery evidence of fetal acidemia, which was defined as pH <7.10. Excluded were stillbirths and neonates with major congenital anomalies. Fetal distress was defined as nonreassuring fetal hearth rate tracing or biophysical profile or appearance of thick meconium at delivery. Statistical analysis included 1-way analysis of variance and logistic regression with a probability value of <.05 considered significant. RESULTS:Neonates with umbilical cord evidence of acidosis (n = 34) were born more frequently after abruption (P < .001), fetal distress (P < .001), and by cesarean delivery (P < .04) and were born less frequently after a complete course of corticosteroids (P = .03) and labor (P = .05) than nonacidotic babies (n = 752). Acute inflammatory lesions at placental histologic evaluation were less frequent (P = .049), and placental vascular lesions were more common in acidotic than in nonacidotic preterm neonates (P = .039). Logistic regression analysis demonstrated that cord acidosis was associated independently with the occurrence of abruptio placentae (odds ratio, 7.3; 95% CI, 2.9, 18.8), fetal distress (odds ratio, 12.0; 95% CI, 4.9, 18.3), and vascular placental lesions (odds ratio, 2.8; 95% CI, 1.2, 6.8) CONCLUSION:In preterm infants, umbilical artery acidosis is significantly more common in the presence of placental abruption, fetal distress, and histologic evidence of placental vascular disease.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Andreani M,Locatelli A,Assi F,Consonni S,Malguzzi S,Paterlini G,Ghidini Adoi
10.1016/j.ajog.2007.07.009subject
Has Abstractpub_date
2007-09-01 00:00:00pages
303.e1-5issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(07)00876-9journal_volume
197pub_type
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journal_title:American journal of obstetrics and gynecology
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更新日期:2008-09-01 00:00:00
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更新日期:2014-03-01 00:00:00
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更新日期:2015-02-01 00:00:00
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更新日期:1994-10-01 00:00:00
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更新日期:1999-08-01 00:00:00
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更新日期:2002-04-01 00:00:00
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doi:10.1067/mob.2003.39
更新日期:2003-02-01 00:00:00
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更新日期:2007-12-01 00:00:00
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更新日期:2019-03-01 00:00:00
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更新日期:2007-03-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-11-01 00:00:00
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更新日期:2006-01-01 00:00:00
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更新日期:1995-02-01 00:00:00
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更新日期:2001-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:1982-01-01 00:00:00
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更新日期:1990-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-09-01 00:00:00