Journal article
Outcomes of extremely low birthweight infants with acidosis at birth
Archives of disease in childhood. Fetal and neonatal edition, Vol.99(4), pp.F263-F268
07/2014
DOI: 10.1136/archdischild-2013-304179
PMID: 24554564
Abstract
Objectives To test the hypothesis that acidosis at birth is associated with the combined primary outcome of death or neurodevelopmental impairment (NDI) in extremely low birthweight (ELBW) infants, and to develop a predictive model of death/NDI exploring perinatal acidosis as a predictor variable. Study design The study population consisted of ELBW infants born between 2002 and 2007 at National Institute of Child Health and Development (NICHD) Neonatal Research Network hospitals. Infants with cord blood gas data and documentation of either mortality prior to discharge or 18–22 month neurodevelopmental outcomes were included. Multiple logistic regression analysis was used to determine the contribution of perinatal acidosis, defined as a cord blood gas with a pH<7 or base excess (BE) <−12, to death/NDI in ELBW infants. In addition, a multivariable model predicting death/NDI was developed. Results 3979 patients were identified of whom 249 had a cord gas pH<7 or BE<−12 mEq/L. 2124 patients (53%) had the primary outcome of death/NDI. After adjustment for confounding variables, pH<7 and BE<−12 mEq/L were each significantly associated with death/NDI (OR=2.5 (1.6, 4.2) and OR=1.5 (1.1, 2.0), respectively). However, inclusion of pH or BE did not improve the ability of the multivariable model to predict death/NDI. Conclusions Perinatal acidosis is significantly associated with death/NDI in ELBW infants. Perinatal acidosis is infrequent in ELBW infants, however, and other factors are more important in predicting death/NDI.
Details
- Title: Subtitle
- Outcomes of extremely low birthweight infants with acidosis at birth
- Creators
- David A Randolph - Department of Pediatrics, Rocky Mountain Hospital for Children, Denver, Colorado, USATracy L Nolen - Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina, USANamasivayam Ambalavanan - Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USAWaldemar A Carlo - Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USAMyriam Peralta-Carcelen - Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USAAbhik Das - Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina, USAEdward F Bell - Department of Pediatrics, University of Iowa, Iowa City, Iowa, USAAlexis S Davis - Department of Pediatrics, Stanford University, Palo Alto, California, USAAbbot R Laptook - Department of Pediatrics, Brown University, Providence, Rhode Island, USABarbara J Stoll - Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USASeetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, Michigan, USARosemary D Higgins - Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), Bethesda, Maryland, USAEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
- Resource Type
- Journal article
- Publication Details
- Archives of disease in childhood. Fetal and neonatal edition, Vol.99(4), pp.F263-F268
- DOI
- 10.1136/archdischild-2013-304179
- PMID
- 24554564
- NLM abbreviation
- Arch Dis Child Fetal Neonatal Ed
- ISSN
- 1359-2998
- eISSN
- 1468-2052
- Language
- English
- Date published
- 07/2014
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093317302771
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