The effect of maternal parameters on umbilical artery blood gas values and neonatal well-being in singleton pregnancies

Year 2016, Volume: 2 Issue: 2, 137 - 142, 04.07.2016

Huseyin Bilgin , Aydin Kosus Nermin Kosus , Semra Kara Abdulkadir Eren Deniz Hizli

https://doi.org/10.18621/eurj.2016.5000169141

Abstract

Background. Umbilical cord blood analysis for assessment of the newborn’s acid-base status soon after birth is the most objective way of evaluating the fetal metabolic condition at delivery. We researched the effects of maternal age, multiple gestation, fetal heart rate, gestational age, parity, delivery mode and total duration of labor on fetal well-being as assessed by umbilical cord blood gas parameters. Methods. Prospective study conducted on 67 singleton pregnant women and their off-spring. Maternal age, multiple gestation, fetal heart rate (FHR), gestational age, parity, delivery mode and total duration of labor were recorded. Umbilical artery blood samples were collected at birth. A blood gas analysis was performed on each collected sample. The relationship between maternal parameters and umbilical cord arterial blood gas were investigated. Results. We found positive correlation between pH and gravida and parity (p=0.026, p=0.049, respectively), whereas negative correlation between total duration of labor and O₂ saturation (p=0.033). Base deficit was negatively correlated with gravida and parity (p=0.025, p=0.011, respectively). In linear regression models, FHR and gravida were a significant predictor of pH value (p=0.029 and p=0.040, respectively). Conclusions. We found no association between maternal age, gestational age, gravida, parity and duration of labor and neonatal acidemia. Thus, maternal age, gestational age, gravida, parity and duration of labor may not be at increased risk of perinatal morbidity. However, the elevation of FHR was related with an increased risk of neonatal morbidity. 

Keywords

Blood gas analysis, umbilical, newborn, outcome, neonatal well-being, maternal parameters

References

• Hamilton BE, Hoyert DL, Martin JA, Strobino DM, Guyer B. Annual summary of vital statistics: 2010-2011. Pediatrics 2013;131:548-58.
• MacDorman MF. Race and ethnic disparities in fetal mortality, preterm birth, and infant mortality in the United States: an overview. Semin Perinatol 2011;35:200-8.
• Zhang X, Kramer MS. Variations in mortality and morbidity by gestational age among infants born at term. J Pediatr 2009;154:358-62.
• Luke B, Brown MB. The changing risk of infant mortality by gestation, plurality, and race: 1989-1991 versus 1999-2001. Pediatrics 2006;118:2488-97.
• Gaudino JA, Hoyert DL, MacDorman MR, Gazmararian JA, Adams MM and Kiely JL. Fetal Deaths. In: From Data to Action, CDC's Public Heath Surveillance for Women, Infants, and Children, Wilcox LS, Marks JS (Eds), US Department of Health and Human Services, Public Health Service, Washington, DC; 1994, p. 163-78.
• ACOG Practice Bulletin No. 102: management of stillbirth. Obstet Gynecol 2009;113(3):748-61.
• Goldaber KG, Gilstrap LC 3rd. Correlations between obstetric clinical events and umbilical cord blood acid-base and blood gas values. Clin Obstet Gynecol 1993;36:47-59.
• Gordon A, Johnson JW. Value of umbilical blood acid-base studies in fetal assessment. J Reprod Med 1985;30:329-36.
• Low JA. Intrapartum fetal asphyxia: definition, diagnosis, and classification. Am J Obstet Gynecol 1997;176:957-9.
• Fretts RC, Schmittdiel J, McLean FH, Usher RH, Goldman MB. Increased maternal age and the risk of fetal death. N Engl J Med 1995;333:953-7.
• Reddy UM, Ko CW, Willinger M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol 2006;195:764-70.
• Froen JF, Arnestad M, Frey K, Vege A, Saugstad OD, Stray-Pedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986-1995. Am J Obstet Gynecol 2001;184:694-702.
• Huang DY, Usher RH, Kramer MS, Yang H, Morin L, Fretts RC. Determinants of unexplained antepartum fetal deaths. Obstet Gynecol 2000;95:215-21.
• Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 2011;284:31-7.
• Salem Yaniv S, Levy A, Wiznitzer A, Holcberg G, Mazor M, Sheiner E. A significant linear association exists between advanced maternal age and adverse perinatal outcome. Arch Gynecol Obstet 2011;283:755-9.
• Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol 2008;112:661-6.
• Benian A, Uludag S, Atis A, Gok M, Madazli R. Analysis of umbilical cord blood acid-base status at birth. Cerrahpasa J Med 2002;33:236-44.