Document Detail

The association of hypotonia and depression in the term and near-term neonate with metabolic acidemia.
MedLine Citation:
PMID:  18211252     Owner:  NLM     Status:  MEDLINE    
AIMS: To determine the association of hypotonia and depression in neonates at or near term with metabolic acidemia at birth (umbilical arterial pH<7.0 and base excess <-12 mM). METHODS: This case-control study identified 87 infants without chromosomal or congenital abnormalities born at a single university hospital between 7/91 and 10/04 with hypotonia at birth requiring resuscitation and admission to the neonatal intensive care unit that had a cord gas at delivery. Controls were the subsequent delivery with a cord gas matched by gestational age. RESULTS: Cases and controls did not differ in gestational age (38.7+/-1.9, 38.6+/-1.9 weeks) or birth weight (3,066+/-664, 3,171+/-655 g, P=0.20). Cases were more likely to have a cord pH<7.0 [17 (20%) vs. 1 (1.1%), P=0.0001] and cord pH 7.0-7.1 [13 (14.9%) vs. 2 (2.3%), P=0.003]. Among the hypotonic infants, 31 (35.6%) also were depressed at birth with a 5-min Apgar <7. In the depressed subset of hypotonic neonates 14/31 (45%) had a pH<7.0. Of the 12 hypotonic neonates with seizures, 3 (25%) had pH<7.0. Multivariate analysis showed a significant association between neonatal hypotonia and hypoglycemia, umbilical arterial pH, and nucleated red blood cell count. CONCLUSIONS: Although metabolic acidemia is significantly associated with hypotonia at the time of birth, the majority of neonates with hypotonia and depression or seizures do not have objective evidence of asphyxia as measured by a cord gas at the time of delivery.
Anadir M Silva; Alice C Cootauco; Abimbola Aina-Mumuney; Pamela K Donohue; Ernest M Graham
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  36     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  151-6     Citation Subset:  IM    
Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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MeSH Terms
Acidosis / complications*
Asphyxia Neonatorum / etiology*
Blood Gas Analysis
Case-Control Studies
Fetal Blood / chemistry*
Gestational Age
Hydrogen-Ion Concentration
Infant, Newborn
Muscle Hypotonia / etiology*
Seizures / etiology*

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