{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T08:11:24Z","timestamp":1698739884702},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,3]],"date-time":"2013-05-03T00:00:00Z","timestamp":1367539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p><jats:italic>The<\/jats:italic> \u2018two\u2010step\u2019 head\u2010to\u2010body delivery method, which involves waiting for the next contraction to deliver the shoulders, causes a decrease in umbilical artery <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>. The aim of this study was to assess whether foetal acidemia activates gluconeogenesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We tested umbilical artery cord blood glucose concentration and <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> after 341 spontaneous and 25 vacuum extractor \u2018two\u2010step\u2019 vaginal deliveries (VD) and after 85 elective and 49 emergency caesarean sections (CS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cord blood glucose concentration was significantly higher (95.5\u00a0\u00b1\u00a021.<jats:styled-content>4<\/jats:styled-content>\u00a0mg\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content> vs 75.6\u00a0\u00b1\u00a016.4, p\u00a0&lt;\u00a00.001), and pH values significantly lower (7.31\u00a0\u00b1\u00a00.09 vs 7.33  \u00b1\u00a00.06, p\u00a0=\u00a00.003) in \u2018two\u2010step\u2019 VD neonates than in CS delivered neonates. In addition, cord blood glucose concentration was significantly higher (101.4\u00a0\u00b1\u00a030.6\u00a0mg\/dL, p  =  0.004), and <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> values were significantly lower (7.26\u00a0\u00b1\u00a00.10, p\u00a0&lt;\u00a00.001) in VD by vacuum extractor than in all other groups. The cord blood glucose concentration is significantly and negatively correlated with <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> in the study population (r\u00a0=\u00a0\u22120.094, p\u00a0=\u00a00.036) and strongly significantly and negatively correlated in VD by vacuum extractor (r\u00a0=\u00a0\u22120.594, p\u00a0=\u00a00.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cord blood glucose concentrations are significantly higher and <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> values significantly lower in \u2018two\u2010step\u2019 VD neonates, indicating activated foetal gluconeogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.12261","type":"journal-article","created":{"date-parts":[[2013,4,11]],"date-time":"2013-04-11T16:01:17Z","timestamp":1365696077000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u2018Two\u2010step\u2019 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