Newborn complications after intrapartum asphyxia with metabolic acidosis in the term fetus

Am J Obstet Gynecol. 1994 Apr;170(4):1081-7. doi: 10.1016/s0002-9378(94)70101-6.


Objectives: Our purpose was to determine the newborn complications after respiratory or metabolic acidosis at delivery and to demonstrate the characteristics of an asphyxial insult predictive of these complications.

Study design: Fifty-nine term fetuses with metabolic acidosis were matched with 59 fetuses with normal blood gas measures at delivery. Fifty-one fetuses with respiratory acidosis were also examined. A complication score expressed the magnitude of newborn complications during the 10 days after delivery.

Results: Newborn complications were not increased after respiratory acidosis. Newborn complications after metabolic acidosis increase in frequency and severity with the increasing severity and duration of the metabolic acidosis. Thirty-two of the 59 newborns in the metabolic acidosis group had a high complication score. The index values predictive of high scores were the duration of the metabolic acidosis and the Apgar score at 1 minute.

Conclusions: Intrapartum fetal asphyxia with a severe metabolic acidosis accounts for complications in all newborn systems. The probability of a high complication score increases from 14% with favorable index values to 85% with unfavorable index values.

MeSH terms

  • Acidosis / complications*
  • Acidosis, Respiratory / complications
  • Apgar Score
  • Asphyxia Neonatorum / complications*
  • Humans
  • Infant, Newborn