Juyoung Lee1, Mee Hong2, Sook Kyung Yum3, Jung Hyun Lee4. 1. Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. 2. Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Seoul, South Korea. 3. Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. 4. Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Seoul, South Korea. ljhped@catholic.ac.kr.
Abstract
PURPOSE: Severe acidosis is one of the strongest predictors of neurologic outcomes in full-term infants with suspected hypoxic-ischemic encephalopathy. However, the relative importance of acidosis as a predictor of outcomes in preterm infants is much less clear. The goals of the present study were to examine the association between postnatal acidosis and severe intraventricular hemorrhage (IVH) and to establish a new score model including acid-base status after birth for predicting the risk of this morbidity. METHODS: The study sample was very low birth weight (VLBW) infants in the Korean Neonatal Network (KNN) cohort registry, collected prospectively from January 2013 to December 2014. Infants with blood pH and base deficit (BD) values collected within the first hour after birth, and documentation of severe IVH, were included. Multivariate stepwise logistic regression analysis was used to determine the contribution of postnatal acidosis to predicting severe IVH in VLBW infants. In addition, a prediction model was developed. RESULTS: Data from 2518 VLBW infants were analyzed. Infants with postnatal acidosis had a higher incidence of severe IVH. The clinical model plus blood BD values improved predictive performance, compared with models using only perinatal data or blood pH. CONCLUSIONS: A prediction model for severe IVH was developed using the KNN registry of VLBW infants. Immediate postnatal acidosis, defined based on blood BD, was associated with a higher-risk-adjusted incidence of severe IVH.
PURPOSE: Severe acidosis is one of the strongest predictors of neurologic outcomes in full-term infants with suspected hypoxic-ischemic encephalopathy. However, the relative importance of acidosis as a predictor of outcomes in preterm infants is much less clear. The goals of the present study were to examine the association between postnatal acidosis and severe intraventricular hemorrhage (IVH) and to establish a new score model including acid-base status after birth for predicting the risk of this morbidity. METHODS: The study sample was very low birth weight (VLBW) infants in the Korean Neonatal Network (KNN) cohort registry, collected prospectively from January 2013 to December 2014. Infants with blood pH and base deficit (BD) values collected within the first hour after birth, and documentation of severe IVH, were included. Multivariate stepwise logistic regression analysis was used to determine the contribution of postnatal acidosis to predicting severe IVH in VLBW infants. In addition, a prediction model was developed. RESULTS: Data from 2518 VLBW infants were analyzed. Infants with postnatal acidosis had a higher incidence of severe IVH. The clinical model plus blood BD values improved predictive performance, compared with models using only perinatal data or blood pH. CONCLUSIONS: A prediction model for severe IVH was developed using the KNN registry of VLBW infants. Immediate postnatal acidosis, defined based on blood BD, was associated with a higher-risk-adjusted incidence of severe IVH.
Authors: Haim Bassan; Kimberlee Gauvreau; Jane W Newburger; Miles Tsuji; Catherine Limperopoulos; Janet S Soul; Gene Walter; Peter C Laussen; Richard A Jonas; Adré J du Plessis Journal: Pediatr Res Date: 2004-11-05 Impact factor: 3.756
Authors: Ju Young Lee; Han Suk Kim; Euiseok Jung; Eun Sun Kim; Gyu Hong Shim; Hyun Joo Lee; Jin A Lee; Chang Won Choi; Ee-Kyung Kim; Beyong Il Kim; Jung-Hwan Choi Journal: J Korean Med Sci Date: 2010-02-17 Impact factor: 2.153