Document Detail

Early postnatal changes in the perfusion index in term newborns with subclinical chorioamnionitis.
MedLine Citation:
PMID:  15863488     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Chorioamnionitis (HCA) in term newborns is often subclinical and associated with neonatal morbidity and mortality. OBJECTIVE: To assess the value of the pulse oximetry perfusion index (PI) in the early prediction of subclinical HCA in term newborns. METHODS: PI cut-off values were first identified in 51 term newborns with HCA and 115 matched controls, retrospectively categorised on the basis of placental histology (study phase 1). The PI thresholds obtained were subsequently tested on an unselected case series of 329 prospectively recruited, term newborns (study phase 2). PI was evaluated during the first five minutes after delivery. Initial illness severity and short term clinical outcomes were determined. RESULTS: In study phase 1, newborns with HCA had lower PI one and five minutes (p<0.0001) after delivery, lower one minute Apgar score (p = 0.017), lower cord blood base excess (p = 0.0001), together with higher rates of admission to neonatal intensive care unit (p = 0.0001) and endotracheal intubation (p = 0.017), and higher SNAP-PE (p<0.0001) and NTISS (p<0.0001) scores than those without HCA. In the prospective validation phase of the study, the PI cut-off values generated (one minute < or =1.74, five minutes < or =2.18) showed 100% sensitivity, 99.4% specificity, 93.7% positive predictive value, and 100% negative predictive value in identifying subclinical HCA. Early identification of HCA was associated with a decreased rate of admission to intensive care (p = 0.012), as well as lower initial illness severity (p< or =0.0001) and therapeutic intensity (p = 0.0006) than the newborns with HCA in phase 1. CONCLUSION: These findings suggest that early PI monitoring is helpful in identifying HCA in term newborns.
C De Felice; A Del Vecchio; M Criscuolo; A Lozupone; S Parrini; G Latini
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Publication Detail:
Type:  Journal Article     Date:  2005-04-29
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  90     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-22     Completed Date:  2005-10-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F411-4     Citation Subset:  AIM; IM    
Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
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MeSH Terms
Apgar Score
Body Temperature
Chorioamnionitis / diagnosis*,  pathology,  physiopathology
Fetal Blood / metabolism
Foot / blood supply
Infant, Newborn
Oximetry / methods
Prospective Studies
Regional Blood Flow
Retrospective Studies
Risk Factors
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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