{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:00:13Z","timestamp":1780524013329,"version":"3.54.1"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003To test the hypothesis that elevated umbilical artery (UA) partial pressure of carbon dioxide (pCO2) is associated with neonatal morbidity and to compare the risk of neonatal morbidity with different patterns of UA acidosis.<\/jats:p><jats:p>\n            Study Design\u2003This was a secondary analysis of a prospective cohort of term, singleton, nonanomalous deliveries with universal cord gas collection. The primary outcome was composite neonatal morbidity. Multivariable logistic regression was used to determine the relative risk (RR) for neonatal morbidity in patients with and without UA hypercarbia. A receiver operating characteristic curve determined the predictive value of pCO2 for neonatal morbidity. An additional multivariable logistic regression was used to evaluate the risk of neonatal morbidity in different patterns of UA acidosis.<\/jats:p><jats:p>\n            Results\u2003UA hypercarbia was associated with an increased risk of neonatal morbidity (RR: 2.56, 95% confidence interval [CI]: [2.07, 3.17]). After adjusting for UA acidemia, this association remained significant (adjusted RR: 1.39, 95% CI: [1.05, 1.83]). UA pCO2 was less predictive of neonatal morbidity than UA pH (area under the curve [AUC]: 0.65, 95% CI: [0.62, 0.68] vs. AUC: 0.72, 95% CI: [0.69, 0.75], p\u2009&lt;\u20090.01). The odds ratios for neonatal morbidity for respiratory, mixed, and metabolic acidosis compared with normal cord gases were 1.48 (95% CI: [0.88, 2.49]), 6.41 (95% CI: [3.68, 11.17]), and 7.49 (95% CI: [5.76, 9.72]), respectively, p-trend\u2009&lt;\u20090.01.<\/jats:p><jats:p>\n            Conclusion\u2003UA hypercarbia is an independent predictor of neonatal morbidity, even in the setting of concomitant UA acidemia. UA mixed and metabolic acidosis carry significantly greater risk of neonatal morbidity compared with respiratory acidosis.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1759721","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T23:48:10Z","timestamp":1671666490000},"page":"e1001-e1007","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["The Risk of Neonatal Morbidity in Umbilical Artery Hypercarbia and Respiratory Acidosis"],"prefix":"10.1055","volume":"41","author":[{"given":"Drew","family":"Hensel","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1041-1535","authenticated-orcid":false,"given":"Leilah","family":"Zahedi-Spung","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebony B.","family":"Carter","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison G.","family":"Cahill","sequence":"additional","affiliation":[{"name":"Department of Women's Health, The University of Texas at Austin Dell Medical School, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Raghuraman","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-9399","authenticated-orcid":false,"given":"Joshua I.","family":"Rosenbloom","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"},{"name":"Faculty of Medicine, Department of Obstetrics and Gynecology, Hadassah Medical Organization, The Hebrew University of Jerusalem, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3389\/fped.2019.00489","article-title":"A global view of neonatal asphyxia and resuscitation","volume":"7","author":"R Moshiro","year":"2019","journal-title":"Front Pediatr"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"c1471","DOI":"10.1136\/bmj.c1471","article-title":"Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis","volume":"340","author":"G L Malin","year":"2010","journal-title":"BMJ"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0002-9378(97)70080-2","article-title":"Threshold of metabolic acidosis associated with newborn complications","volume":"177","author":"J A Low","year":"1997","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.jmwh.2005.08.007","article-title":"Intrauterine asphyxia: clinical implications for providers of intrapartum care","volume":"50","author":"J Fahey","year":"2005","journal-title":"J Midwifery Womens Health"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1067\/mob.2002.123204","article-title":"Use of umbilical artery base excess: algorithm for the timing of hypoxic injury","volume":"187","author":"M G Ross","year":"2002","journal-title":"Am J Obstet Gynecol"},{"key":"ref6","volume-title":"Creasy & Resnik's Maternal-Fetal Medicine: Principles and Practice","author":"R Resnik","year":"2019","edition":"8th ed."},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/0002-9378(89)90410-9","article-title":"Diagnosis of birth asphyxia on the basis of fetal pH, Apgar score, and newborn cerebral dysfunction","volume":"161","author":"L C Gilstrap III","year":"1989","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/01.AOG.0000445580.65983.d2","article-title":"Executive summary: neonatal encephalopathy and neurologic outcome, second edition. 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