Document Detail

Laboratory markers of perinatal acidosis are poor predictors of neurodevelopmental impairment in very low birth weight infants.
MedLine Citation:
PMID:  21658869     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In asphyxiated term and near-term infants, therapeutic hypothermia increases survival without neurologic morbidity, and extending this new treatment to preterm infants is being debated.
AIMS: To investigate the association of low pH and base excess (BE) at birth or admission, as used as entry criteria in cooling trials, and evolving brain damage in preterm infants.
STUDY DESIGN AND MEASUREMENTS: Rates of death and neurodevelopmental impairment at 12 and 20 months corrected age were assessed in a cohort of 1137 preterm infants with a gestational age <35 weeks and birth weight <1500 g in relation to severe perinatal acidosis (umbilical artery pH≤7.0, pH at admission ≤7.0, BE at admission ≤-16 mmol/l, lowest BE during first 12 h of life ≤-16 mmol/l).
RESULTS: Umbilical artery pH was not linked to death or neurodevelopmental impairment. There was only weak predictive power of pH or BE at admission for death (positive predictive values [PPV] 0.36/0.30, receiver operator characteristics [ROC] areas 0.591/0.701), and lowest 12-h BE for death or neurodevelopmental impairment at 12 or 20 months (PPV 0.29/0.30/0.27, ROC 0.720/0.656/0.658).
CONCLUSION: In very preterm infants, there is little association between laboratory markers of severe perinatal acidosis and neurodevelopmental outcome at 12 or 20 months.
Dieter Hüseman; Boris Metze; Elisabeth Walch; Christoph Bührer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-11
Journal Detail:
Title:  Early human development     Volume:  87     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-23     Completed Date:  2012-02-02     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  677-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Dept of Neonatology, Charité University Medical Center, Berlin, Germany.
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MeSH Terms
Acidosis / blood*,  complications*,  mortality
Asphyxia Neonatorum / complications
Biological Markers / blood
Birth Weight
Cohort Studies
Developmental Disabilities / blood,  etiology*
Gestational Age
Hydrogen-Ion Concentration
Infant, Newborn
Infant, Premature, Diseases / blood*,  mortality
Infant, Very Low Birth Weight / blood,  growth & development*
ROC Curve
Umbilical Arteries
Reg. No./Substance:
0/Biological Markers

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