Sabol and Caughey evaluated outcomes for neonates. Measuring pH and base excess in the umbilical cord can help to identify a neonate who is likely to have problems despite a 5-minute Apgar score >= 7. The authors are from Oregon Health and Science University in Portland.

Patient selection: neonate with 5-minute Apgar score >= 7



(1) umbilical cord blood pH

(2) umbilical cord blood base excess in mmol/L (a negative base excess indicates acidemia)


Umbilical cord blood lactate was not reported.


Cutoffs for pH: <= 7.0 and <= 7.1


Cutoffs for base excess: <= -12 and <= -10 mmol/L


The presence of umbilical cord pH <= 7.1 and base excess <= -10 mmol/L were associated with increased risk for:

(1) neonatal ICU admission

(2) neonatal sepsis

(3) respiratory distress syndrome

(4) meconium aspiration syndrome


The authors recommend universal umbilical cord blood gas testing.

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