December 2011. Volume 7. Number 4

Rethinking the umbilical cord pH. Is it useful for assessing perinatal asphyxia and its consequences?

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

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:c1471.
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 11/09/2011
Acceptance date: 18/09/2011
Publication date: 21/09/2011

Abstract

Authors’ conclusions: low arterial cord pH showed strong, consistent, and temporal association with clinically important neonatal outcomes that are biologically plausible. These data could justify the increased surveillance of infants born with a low cord pH.

Reviewers’ commentary: there is a clear relationship between fetal acidosis and perinatal asphyxia, this systematic review also shows that the association between low pHAU and neonatal morbidity and mortality is not limited to populations at risk. This finding reopens the debate on whether we should make cord pH at every birth. That depends on whether this test provides an appropriate balance of risks, costs and benefits. Considering that this test can be done safely during delivery at low price, the key question would be: do we need to make a close follow up of all infants with low pHAU even without perinatal asphyxia? In this case the main "cost" would be the effect of labelling and the false positives. In our opinion, the pHAU is a useful data if available at all births, but current studies suggest recommend only a close follow up at medium to long term of newborns with pHAU when it is associated with perinatal asphyxia.

How to cite this article

González de Dios J, Balaguer Santamaría A. Reconsiderando el pH de arteria umbilical: ¿sirve para valorar la asfixia perinatal y sus consecuencias? Evid Pediatr. 2011;7:84.

AVC | Critically appraised articles

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:c1471.
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 11/09/2011
Acceptance date: 18/09/2011
Publication date: 21/09/2011

How to cite this article

González de Dios J, Balaguer Santamaría A. Reconsiderando el pH de arteria umbilical: ¿sirve para valorar la asfixia perinatal y sus consecuencias? Evid Pediatr. 2011;7:84.

References

  1. González de Dios J. Definición de asfixia perinatal en la literatura médica: necesidad de un consenso. Rev Neurol (Barc). 2002;35:628-34.
  2. González de Dios J, Moya M, Vioque J. Factores de riesgo predictivos de secuelas neurológicas en recién nacidos a término con asfixia perinatal. Rev Neurol (Barc). 2001;32:210-6.
  3. Van de Riet JE, Vandenbussche FP, Le Cessie S, Keirse MJ. Newborn assessment and long-term adverse outcome: a systematic review. Am J Obstet Gynecol. 1999;180:1024-9.
21/09/2011

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