PMID- 31776075
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1769-664X (Electronic)
IS  - 0929-693X (Linking)
VI  - 27
IP  - 1
DP  - 2020 Jan
TI  - Neonatal cord blood eucapnic pH: A potential biomarker predicting the need for 
      transfer to the NICU.
PG  - 6-11
LID - S0929-693X(19)30195-2 [pii]
LID - 10.1016/j.arcped.2019.10.013 [doi]
AB  - INTRODUCTION: The best biomarker for neonatal metabolic acidosis (NMA) and its 
      related complications is still a matter of debate. Umbilical artery (Ua) cord pH 
      is not sufficiently specific, as is lactatemia, while base deficit is considered 
      to offer no added value. From a physiological point of view, the calculated 
      neonatal eucapnic pH is a more specific marker for neonatal metabolic acidosis 
      and may be a better predictor of birth complications of hypoxic origin, because 
      complications related to asphyxia are always preceded by neonatal depression 
      leading to a transfer to a neonatal intensive care unit (NICU) for close 
      monitoring. OBJECTIVE: This study aimed to test the hypothesis that in a group of 
      neonates with significant acidemia, neonatal eucapnic pH (pH euc-n) predicts NICU 
      admission better than the Ua cord pH does. METHODS: From a cohort of 5,392 
      infants all born at >/=35 weeks' gestation, we identified a group of 30 cases with 
      Ua cord pH <7.0. We calculated the area under the curve (AUC) for pH euc-n and Ua 
      cord pH using the receiver-operating characteristic (ROC) curve and compared the 
      performance of these biological markers in predicting transfer to the NICU. 
      Cut-off points were determined by selecting the best value of the positive 
      likelihood ratio that maximizes the accuracy of prediction. RESULTS: From the 30 
      newborns diagnosed with significant acidemia, four infants were transferred to 
      the NICU. No case of neonatal encephalopathy was observed. In these infants, the 
      pH euc-n AUC (0.66) was significantly higher than the Ua cord pH AUC (0.44) 
      (P<0.005), with the best pH euc-n cut-off value at 7.11. CONCLUSION: Despite the 
      study limitations, our results suggest that pH euc-n is a better marker than Ua 
      pH for predicting admission to the NICU in newborns with acidemia at birth. These 
      are preliminary results and further investigations are mandatory in larger 
      population samples to confirm these findings and to determine the optimal cut-off 
      value for pH euc-n for the most accurate prediction of a complicated transition 
      to extrauterine life and, potentially, neonatal hypoxic-ischemic encephalopathy.
CI  - Copyright (c) 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. 
      All rights reserved.
FAU - Racinet, C
AU  - Racinet C
AD  - Registre des handicaps de l'enfant et Observatoire Perinatal, 38000 Grenoble, 
      France; Obstetrics & Gynecology, Universite Grenoble-Alpes, 38400 St Martin 
      d'Heres, France. Electronic address: claude.racinet@laposte.net.
FAU - Ouellet, P
AU  - Ouellet P
AD  - Department of Surgery, Universite de Sherbrooke, Sherbrooke, Quebec, Canada; 
      Vitalite Health Network, North West Zone, Edmundston, New Brunswick, Canada.
FAU - Muraskas, J
AU  - Muraskas J
AD  - Division of Neonatology, Obstetrics and Gynecology, Maternal/Fetal Medicine, 
      Loyola University Medical Center, Maywood, IL, USA.
FAU - Daboval, T
AU  - Daboval T
AD  - University of Ottawa, Division of Neonatology Children's Hospital of Eastern 
      Ontario, Ottawa, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20191124
PL  - France
TA  - Arch Pediatr
JT  - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
JID - 9421356
RN  - 0 (Biomarkers)
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - Acidosis/*diagnosis
MH  - Biomarkers/blood
MH  - Carbon Dioxide/blood
MH  - Cohort Studies
MH  - Female
MH  - Fetal Blood/*physiology
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Hypoxia-Ischemia, Brain/blood
MH  - Infant, Newborn
MH  - Infant, Newborn, Diseases
MH  - Intensive Care Units, Neonatal
MH  - Male
MH  - ROC Curve
OTO - NOTNLM
OT  - Base deficit
OT  - Birth depression
OT  - Hypoxic-ischemic events
OT  - Metabolic acidosis
OT  - NICU
OT  - Neonatal acidemia
OT  - Neonatal encephalopathy
OT  - Respiratory acidosis
EDAT- 2019/11/30 06:00
MHDA- 2020/11/11 06:00
CRDT- 2019/11/29 06:00
PHST- 2019/04/08 00:00 [received]
PHST- 2019/08/05 00:00 [revised]
PHST- 2019/10/20 00:00 [accepted]
PHST- 2019/11/30 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2019/11/29 06:00 [entrez]
AID - S0929-693X(19)30195-2 [pii]
AID - 10.1016/j.arcped.2019.10.013 [doi]
PST - ppublish
SO  - Arch Pediatr. 2020 Jan;27(1):6-11. doi: 10.1016/j.arcped.2019.10.013. Epub 2019 
      Nov 24.