Relationship between Apgar score and umbilical cord blood acid-base balance in full-term and late preterm newborns born in medium and severe conditions.

Abstract

Application of Apgar scores (AS) and umbilical cord blood acid-base analysis is a base for the prediction of future neurological development in children. In clinical practice we often observe huge discrepancy between clinical and biochemical status of newborn. Because many obstetricians consider both assessments as substitute and measure of their proceeding's outcome, we decided to scientifically measure actual correlation between them among newborns born with Apgar less than 8 points. This was an observational retrospective study. The study included 141 newborns born in general medium and severe condition (Apgar < 8 points in first minute of life). Acid-base analysis of umbilical cord vein blood immediately after birth was performed. We correlated gasometer parameters with Apgar scores of newborns. The clinical condition of a newborn at 1, 5, and 10 minutes after birth correlates positively and significantly with pH values (0.25; 0.24; and 0.26; respectively) and bicarbonate levels (0.21; 0.27; 0.28; respectively) in the umbilical cord vein, however correlation was low. Subsequently we qualified newborns to four groups depending on the degree of invasiveness of respiratory support after delivery, and the groups were compared in terms of parameters of acid-based balance. No significant differences were observed between groups in terms of acid-base balance parameters. There is low, but significant correlation between clinical condition of a newborn after birth with most of acid-base parameters from umbilical vein blood. The assessment of the newborn's condition after birth using the Apgar score, (but not acid-base parameters) determines the degree of invasiveness of respiratory support activities for newborns after birth.