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Am J Perinatol 2018; 35(04): 331-335
DOI: 10.1055/s-0037-1607318
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Umbilical Cord Oxygen Content and Neonatal Morbidity at Term

Nandini Raghuraman
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Lorene A. Temming
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Molly J. Stout
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
George A. Macones
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Alison G. Cahill
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Methodius G. Tuuli
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations Funding Dr. Cahill is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061619-01, PI Cahill) and was a Robert Wood Johnson Foundation Faculty Physician Scholar, which partially supported this work. Dr. Temming is supported by a NIH T32 training grant (5T32HD055172-07). This publication was also made possible by grant number UL1 TR000448 from the NIH National Center for Advancing Translational Sciences (NCATS), components of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of the NIH or Robert Wood Johnson Foundation. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Robert Wood Johnson Foundation or NIH.
Further Information

Publication History

03 June 2017

14 September 2017

Publication Date:
11 October 2017 (online)

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Abstract

Objective The objective of this study was to investigate the relationship between umbilical cord partial pressure of oxygen (pO2) at delivery and neonatal morbidity.

Study Design This is a secondary analysis of a prospective cohort study of term deliveries with universal cord gas collection between 2010 and 2014. The primary composite outcome of neonatal morbidity included neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermia treatment. Umbilical artery (UA), vein (UV), UV minus UA (Δ) pO2, and hypoxemia (pO2 ≤ fifth percentile) were compared between patients with and without neonatal morbidity. Areas under the receiver-operating characteristic curves were used to assess the predictive ability of pO2.

Results Of 7,789 patients with paired umbilical cord pO2, 106 (1.4%) had the composite neonatal morbidity. UA pO2 was significantly lower in patients with neonatal morbidity compared with those without (median [interquartile range]: 16 (12, 21) vs. 19 (15, 24) mm Hg, p < 0.001). There was no difference in median UV pO2 or ΔpO2 between the groups. UA and UV hypoxemia were significantly more common in patients with neonatal morbidity. UA pO2 had limited predictive ability for neonatal morbidity (area under the curve: 0.61, 95% confidence interval: 0.6–0.7).

Conclusion Although UA pO2 is significantly lower in patients with neonatal morbidity, it is a poor predictor of neonatal morbidity at term.

Keywords

cord gas - umbilical artery - pO2 - neonatal morbidity - oxygen

Note

This study was presented at the Society for Reproductive Investigation Annual Meeting, March 15–18, 2017, Orlando, Florida.


 

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