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 - pO
2
- neonatal morbidity - oxygen
