Abstract
The Apgar score correlates poorly with metabolic acidosis at birth. We evaluated the relationship of these 2 parameters to 3 other indices of asphyxia, cord plasma HX, AVP, and EP concentrations, in infants born with acute asphyxia after normal pregnancy. During a 2-month period, at 972 consecutive deliveries, the umbilical cord was doubly clamped immediately after birth. 16 infants had an Apgar score of ≤6 at 5 min (group A). Their mean umbilical arterial (UA) pH was 7.18; only 3 had a pH ≤7.05. 17 infants had an UA-pH of ≤7.05 (group B). Log mean of UA-HX was 15 ymol/1 in group A (n=8) and 32 ymol/1 in group B (n=10). In both groups combined, UA-pH and HX were significantly correlated (r=-0.57). Log mean of UA-AVP was 79 pg/ml in group A (n=5), and 603 pg/ml in group B (n=9). In both groups combined, UA-pH and AVP (r=-0.76) and HX and AVP (r=0.55) were correlated. Log mean of UV-EP was 32 mU/ml in group A (n=8) and 44 mU/ml in group B (n=13). UA-pH and UV-EP, nor any of the parameters and Apgar score were correlated. We conclude that UA-pH, HX, and AVP are related indices of acute birth asphyxia, defining a risk group different from that defined by Apgar score UV-EP does not reflect acute asphyxia, which is in line with the known delay between a hypoxic insult and EP response.
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