The association of hypotonia and depression in the term and near-term neonate with metabolic acidemia
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Anadir M. Silva
Abstract
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 (3066±664, 3171±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.
©2008 by Walter de Gruyter Berlin New York
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- Prenatal long-chain polyunsaturated fatty acid status: the importance of a balanced intake of docosahexaenoic acid and arachidonic acid
- Population-based standardization (PBS) of institutional cesarean delivery rates
- Impact of high maternal hemoglobin at first antenatal visit on pregnancy outcomes: a cohort study
- Retrospective audit of outcome of regional anesthesia for delivery in women with thrombocytopenia
- The association between maternal characteristics and different types and levels of discordance in triplet pregnancies
- Obstetric gel shortens second stage of labor and prevents perineal trauma in nulliparous women: a randomized controlled trial on labor facilitation
- Fetal electrocardiographic monitoring during labor in relation to cord blood levels of the brain-injury marker protein S-100
- Nuchal cord in post-term pregnancy – relationship to suspected intrapartum fetal distress indicating operative intervention
- Risk assessment of trisomy 21 by maternal age and fetal nuchal translucency thickness in 7096 unselected pregnancies in Slovenia
- The association of hypotonia and depression in the term and near-term neonate with metabolic acidemia
- 17-Hydroxyprogesterone in premature infants as a marker of intrauterine stress
- Prenatal hypoxia preconditioning improves hypoxic ventilatory response and reduces mortality in neonatal rats
- Mortality and morbidity of neonates born at <26 weeks of gestation (1998–2003). A population-based study
- Conception without the development of a human being
- Intraplacental choriocarcinoma with fetomaternal hemorrhage: a case study and literature review
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