Arteriovenous differences in cord blood gas analysis and the prediction of adverse neonatal outcome

摘要

Abstract Introduction The aim of this paper was to determine whether arteriovenous differences of pH and pCO 2 are useful predictors of adverse neonatal outcome in acidemic neonates. Material and methods An established database of 8759 term, singleton, non‐anomalous neonates with validated cord gases and outcomes [Encephalopathy (Grade 2/3), Apgar 7 at five minutes and composite neonatal outcomes of neurological and systemic involvement] was used. Analysis was of the cohort of the 520 acidemic (arterial pH 7.10) neonates. Chi‐square tests with odds ratio ( OR ), 95% CI were calculated for dichotomous cut‐offs of differences; hierarchical logistic regression was used to examine the predictive performance over and above arterial pH . Results Arteriovenous hydrogen ion concentration ([H + ion]) differences do not predict neonatal outcomes except low Apgar scores, and large pCO 2 differences are associated with worse neonatal outcomes. Nevertheless, neonates with large arteriovenous [H + ion] and pCO 2 differences have lower arterial pH values. Hierarchical regression demonstrates that arteriovenous pCO 2 differences do not add predictive value beyond arterial pH and arteriovenous [H + ion] adds only to the prediction of low Apgar scores. Conclusions Arteriovenous differences of [H + ion] and pCO 2 are not useful independent predictors of adverse neonatal outcomes in acidemic neonates.