Correlation of APGAR score and cord blood pH with severity of birth asphyxia and short-term outcome

Authors

  • Pradeep Meena Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Mahendra Meena Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Maheshwar Gunawat Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20172659

Keywords:

APGAR score, Cord blood pH, Hypoxic ischemic encephalopathy, Perinatal/birth asphyxia

Abstract

Background: Birth/Perinatal asphyxia is one of the common cause of neonatal morbidity and mortality. Morbidity and mortality in asphyxia depends on duration and severity of asphyxia. The present study was carried out to find out the correlation of APGAR score and cord blood pH with severity of birth asphyxia and short-term outcome.

Methods: An observational hospital based prospective study was conducted at inborn NICU, of Medical College Hospital of Southern Rajasthan from March 2015 to September 2015. We enrolled total 50 inborn asphyxiated newborns as cases. The cord blood was collected immediately at delivery for measurement of cord blood arterial blood gas analysis including pH. All the enrolled cases were admitted in the NICU for treatment and observation for complication and immediate neurological outcome. All the admitted newborns were followed till discharge/death for final outcome. The correlation of APGAR score, cord blood pH and outcome was analysed statistically.

Results: The mean APGAR score at 1 min, 5 min and mean cord blood pH in babies with HIE-I were 4.40±0.89, 6.80±0.45 and 7.21±0.11; HIE-II 3.70±0.67, 6.0±1.25 and 7.20±0.06; HIE-III 2.69±0.60, 3.56±0.8 and 7.03±0.11, respectively. Correlation coefficients of APGAR 1 min, 5 min and cord blood pH to predict the severity of birth asphyxia were -0.633, -0.666 and 0.624.

Conclusions: Cord blood pH at birth in combination with APGAR score can be used to predict the severity of birth asphyxia and short-term outcome. APGAR score and cord blood pH are inversely related with the duration and severity asphyxia. 

References

National Neonatal and Perinatal Database Report; 2002- 2003:1-58.

World Health Organization. Neonatal and Perinatal Mortality; Country, Regional and Global estimates, 2004; WHO, Geneva; 2006:1-25.

American Academy of Pediatrics and American College of Obstetrician and Gynaecologists. In: Guidelines for Perinatal Care. Gilstral LC, Oh W (Eds.) 5th Ed. Elk Grove Village III. American Academy of Pediatrics; 2002:187.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A Clinical and Electroencephalographic Study. Arch Neurol. 1976; 33(10):696-705.

Apgar V. A Proposal for a new method of evaluation of the newborn infant. Curr Res Anest Analg. 1953;32(4):260-7.

Field LM, Entman SS, Boehm FH. Correlation of the one minute Apgar score and the pH value of umbilical arterial cord blood. South Med J. 1993; 46(12):1477-9.

Armstrong L, Stenson BJ. Use of umbilical cord blood gas analysis in the assessment of the newborn. Arch Dis Child Fetal Neonatal Ed. 2007;92(6):430-4.

Ross GM, Cola R. Use of umbilical artery base excess: Algorithm for the timing of of hypoxic injury. AM J Obstet Gynecol. 2002;187(1):1-9.

Thop JA, Diidy GA, Yeomans ER, et al. Umbilical cord blood gas analysis at delivery. AM J Obstet Gynecol. 1996;175(3):517-22.

Kaveh M, Davari FT, Farhani MSH. APGAR score and arterial blood gas in the first hour of birth. Iran J Pediatr. 2004;14(1):27-32.

Malin GL, Morris RK, Khan KS. Strength of association between umbilical cord pH and perinatal and long-term outcomes: systematic review and meta-analysis. BMJ. 2010;340:1471.

Downloads

Published

2017-06-21

Issue

Section

Original Research Articles