Acid base and metabolic parameters of the umbilical cord blood and cerebral oxygenation immediately after birth

Martin Dusleag; Berndt Urlesberger; Bernhard Schwaberger; Nariae Baik-Schneditz; Christoph Schlatzer; Christina H Wolfsberger; Gerhard Pichler

doi:10.3389/fped.2024.1385726

Acid base and metabolic parameters of the umbilical cord blood and cerebral oxygenation immediately after birth

Front Pediatr. 2024 Mar 28:12:1385726. doi: 10.3389/fped.2024.1385726. eCollection 2024.

Authors

Martin Dusleag^{1

2}, Berndt Urlesberger^{1

2}, Bernhard Schwaberger^{1

2}, Nariae Baik-Schneditz^{1

2}, Christoph Schlatzer^{1

2}, Christina H Wolfsberger^{1

2}, Gerhard Pichler^{1

2}

Affiliations

¹ Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
² Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

Abstract

Objective: Aim was to investigate whether acid-base and metabolic parameters obtained from arterial umbilical cord blood affect cerebral oxygenation after birth in preterm neonates with respiratory support and in term neonates without respiratory support.

Study design: This was a post-hoc analysis of secondary outcome parameters of a prospective observational study including preterm neonates with and term neonates without respiratory support. Non-asphyxiated neonates with cerebral oxygenation measured with near-infrared spectroscopy during the first 15 min and with blood gas analyses from arterial umbilical cord blood were included. Arterial oxygen saturation (SpO₂) and heart rate (HR) were monitored with pulse oximetry. Potential correlations were investigated between acid-base and metabolic parameters (pH-value, bicarbonate, base-excess, and lactate) and crSO₂/cFTOE 5 min after birth.

Results: Seventy-seven neonates were included: 14 preterm neonates with respiratory support (mean gestational age [GA] 31.4 ± 4.1 weeks; mean birth weight [BW] 1,690 ± 640 g) and 63 term neonates without respiratory support (GA 38.7 ± 0.8 weeks; BW 3,258 ± 443 g). Mean crSO₂ 5 min after birth was 44.0% ± 24.2% in preterm and 62.2% ± 20.01% in term neonates. Mean cFTOE 5 min after birth was 0.46 ± 0.06 in preterm and 0.27 ± 0.19 in term neonates. In preterm neonates with respiratory support higher lactate was significantly associated with lower crSO₂ and SpO₂ and tended to be associated with higher cFTOE. In term neonates without respiratory support no significant correlations were found.

Conclusion: In non-asphyxiated preterm neonates with respiratory support, lactate levels were negatively associated with crSO₂ and SpO₂, whereas in term neonates without respiratory support no associations were observed.

Keywords: acid-base and metabolic parameters; cerebral oxygenation; immediate neonatal transition; near-infrared spectroscopy; neonates.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.