Clinical signs in term infants with different degrees of acidemia in cord blood

OBJECTIVE: To verify if Apgar score plus umbilical cord pH are adequate to predict which newborn infant will develop multiorgan system disfunction. METHODS: A study including all term newborn infants with Apgar scores in the first and fifth minutes of life < 7 and umbilical cord blood pH < 7.20 born in Hospital de Clínicas de Porto Alegre from March 1995 through March 1998 was performed. Venous umbilical cord blood was collected for blood gas analysis. Newborn infants were divided in two groups: Group A with pH < 7.0, and Group B with pH >/= 7.0 and < 7.20. Patients were evaluated for the presence of pulmonary hypertension, renal failure, inappropriate secretion of antidiuretic hormone, ischemic cardiopathy, early seizures, neurologic injury at hospital discharge and death. RESULTS: Twenty five newborn infants were included in the study.Twelve formed Group A, and 13, Group B. There were no differences between both groups in respect to mode of delivery, gender, color and birth weight. Group B had a lower gestational age than Group A. There were significant differences between both groups in mean cord blood pH, pCO(2) and BE (p<0.05). There was a positive association between umbilical cord blood pH and Apgar score. Higher occurrence of neurologic injury at hospital discharge in Group A was the only statistically significant clinical manifestation (p<0.05). CONCLUSION: Apgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.