Predict respiratory distress syndrome by umbilical cord blood gas analysis in newborns with reassuring Apgar score

Abstract

Background: Neonatal acidaemia at birth can increase neonatal morbidity and mortality and it is predictive of neonatal asphyxia. The umbilical blood gas analysis is a valid tool for the evaluation of neonatal acidaemia. However, umbilical cord blood gas analysis is commonly performed in high-risk situations or in the setting of Apgar scores < 7 at 5 min. Methods: A retrospective cohort study was conducted from June to December 2018 at the Department of mother's and child's health, Poliambulanza Foundation Hospital Institute. Inclusion criteria were: full term newborns with body weight appropriate for gestational age, born by vaginal delivery or caesarean section, reassuring Apgar Score > 7 at 5 min, arterial cord blood gas analysis showing pH < 7.4 or BE <-8 mmol/l or lactate > 6 mmol/l. The aim was to evaluate the predictive role of blood gas analysis for respiratory distress syndrome in newborns with reassuring Apgar Score. Results: 352 full term newborns were enrolled. Umbilical cord blood artery pH showed an association with respiratory distress syndrome (χ 2 (1) = 10,084, OR (95% CI): 3,9 × 10 − 4 (2,9 × 10 − 6 -0,048); p < 0,05). ROC curve revealed that the cut-off point of pH was 7.12, with a sensibility and specificity of 68 and 63%, respectively. Conclusions: Umbilical cord blood artery pH < 7.12 at birth is associated to respiratory distress syndrome in newborns. Blood gas analysis is an important instrument to help health care providers during assistance in the delivery room, but also to early identify newborns at high risk for respiratory distress syndrome and better manage the care of these newborns after birth.

Novel predictor markers for early differentiation between transient tachypnea of newborn and respiratory distress syndrome in neonates

“…One study concluded that low blood pH at birth is associated with RDS in newborns and the blood gas analysis is important for early identification of newborns at high risk for RDS, 48 and another study showed that early blood gas analysis may be able to predict RD and both studies were agreed with the results of our study. 14 …”

“…41 In agreement with our results, some studies indicated that the increased OS accompanied by reduced antioxidant defenses may play a significant role in the pathogenesis of RD in preterm newborns 67 and our results agreed with some studies revealed that there was an evidence of oxidative damage and diminished antioxidant defenses in newborns with RDS and the neonatal RDS is associated with certain damage of the cell lipids, proteins and DNA, due to the effect of oxidative stress. 68 One study concluded that low blood pH at birth is associated with RDS in newborns and the blood gas analysis is important for early identification of newborns at high risk for RDS, 48 and another study showed that early blood gas analysis may be able to predict RD and both studies were agreed with the results of our study. 14 In disagreement with our results, some studies stated that cord blood gases did not help in prediction of morbidity in neonates as RDS, and the values of cord blood gas did not predict the presence or severity of RDS, 69 while in agreement with our results, some researches showed that the elevated plasma LDH is strongly related to respiratory system affection in neonates which occur in first days of life especially neonatal RDS.…”

“…Blood gases is very important in detecting and monitoring of respiratory diseases in neonates especially RDS and used as a good follow up of the cases for the need of respiratory support either invasive or non-invasive ventilation. 48 …”

Blood Plasma Metabolic Profile of Newborns with Hypoxic-Ischaemic Encephalopathy by GC-MS

“…Approximately 25% to 30% of survivors may be at risk of lifelong neurological impairment and disabilities [4]. The efficiency of many current existing methods on HIE diagnosis, such as Apgar series score, cord blood gas, cranial ultrasound, and magnetic resonance imaging (MRI), have proven to be controversial and modest due to individual subjectivity, methodological shortcomings, and the complexity of the encephalopathy [5][6][7][8][9][10][11][12]. For instance, MRI, as one of the main popular diagnostic tools, often shows false-negative results due to its low sensitivity [13].…”

Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology

“…Immediate identification of respiratory distress syndrome (RDS) and early treatment is important to reach better outcomes. So, it is important to identify early biomarkers of RDS such as blood gas analysis (BGA) to improve diagnosis [ 163 ]. In 352 full term neonates born from vaginal delivery with Apgar score > 7 at 5 minutes, arterial cord BGA results showed an association with RDS, specifically for arterial cord blood pH < 7.12, in 33.8% of infant.…”