{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:10:39Z","timestamp":1788883839004,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Most infants with a low cord pH have reassuring 5\u2010min Apgar scores of 7\u201310, but their long\u2010term outcomes have been poorly studied. We examined whether cord pH predicted later special educational needs (SEN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This nationwide register\u2010based study was conducted in Denmark, which provides universal cord pH screening. It comprised singletons born after 35\u2009weeks of gestation from 2006 to 2013, with 5\u2010min Apgar scores of 7\u201310 and cord pH values of &lt;\u20097.0, 7.0\u20137.09, and \u2265\u20097.1. Information on SEN was obtained from national registers until June 3, 2020, when the children were 6.5\u201314.5\u2009years of age. Associations between cord pH and SEN were analysed using multivariable Cox regression, and eight\u2010year cumulative incidence estimates were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that 1121 of the 318 486 (0.4%) infants had cord pH values of &lt;\u20097.0 and 8582 (2.7%) had 7.0\u20137.09. The adjusted hazard ratio for SEN was 0.95 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.73) for a cord pH of &lt;\u20097.0 and 0.98 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.72) for 7.0\u20137.09, compared with a pH of \u2265\u20097.1. The eight\u2010year cumulative incidence of SEN was similar in the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cord pH was not associated with later SEN in children born after 35\u2009weeks of gestation who had reassuring 5\u2010min Apgar scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70631","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:26:35Z","timestamp":1780979195000},"page":"2200-2208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No Association Between Umbilical Cord\n                    <scp>pH<\/scp>\n                    and Special Educational Needs Among Children With Normal 5\u2010Minute Apgar Scores"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7201-9518","authenticated-orcid":false,"given":"Celina","family":"Myrh\u00f8j","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Copenhagen University Hospital \u2010 North Zealand  Hilleroed Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harman","family":"Yonis","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital, North Zealand  Hilleroed Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Wiingreen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital \u2010 North Zealand  Hilleroed Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Christine Leth","family":"L\u00f8kkegaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Copenhagen University Hospital \u2010 North Zealand  Hilleroed Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Torp\u2010Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, North Zealand  Hilleroed Denmark"},{"name":"Department of Public Health University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3087-3983","authenticated-orcid":false,"given":"Bo M\u00f8lholm","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital \u2010 North Zealand  Hilleroed Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"\u201cThe Apgar Score \u201dhttps:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/committee\u2010opinion\/articles\/2015\/10\/the\u2010apgar\u2010score."},{"key":"e_1_2_12_3_1","unstructured":"D.Moster R. T.Lie L. M.Irgens T.Bjerkedal andT.Markestad \u201cThe association of Apgar score with subsequent death and cerebral palsy: A population\u2010based study in term infants \u2010 ScienceDirect \u201dhttps:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0022347601511063?via%3Dihub."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1471"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.099846"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14326"},{"key":"e_1_2_12_7_1","article-title":"Cooling for Newborns With Hypoxic Ischaemic Encephalopathy","volume":"1","author":"Jacobs S. E.","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_8_1","volume-title":"Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth","author":"National Collaborating Centre for Women's and Children's Health (UK)","year":"2014"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2010.01192.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2012.03335.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17480"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14572"},{"issue":"486","key":"e_1_2_12_13_1","first-page":"e1","article-title":"Acidemia in Neonates With a 5\u2010Minute Apgar Score of 7 or Greater \u2013 What Are the Outcomes?","volume":"215","author":"Sabol B. A.","year":"2016","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_12_14_1","article-title":"A Systematic Review of the Relationship Between Neonatal Hypoxic\u2010Ischemic Encephalopathy and Long\u2010Term Cognitive Outcomes: Where Do we Stand?","volume":"16","author":"Abusaleem M. Y.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.0217"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000289"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-069500"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0356-1"},{"key":"e_1_2_12_19_1","unstructured":"TIMES \u201cdelopgave \u2010 Grundskole \u201dhttps:\/\/www.dst.dk\/da\/Statistik\/dokumentation\/Times\/uddannelsesdata\/grundskole."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811399958"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394715"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"e_1_2_12_23_1","unstructured":"RKKP \u201cDansk Kvalitetsdatabase for Nyf\u00f8dte (DKN): \u00c5rsrapport 2021. Aarhus: Regionernes Kliniske Kvalitetsudviklingsprogram (RKKP); 2022 \u201dhttps:\/\/sundk.dk\/media\/xbk2yowz\/9afc382e71ca4fa68c181f0b2778c4b9.pdf."},{"key":"e_1_2_12_24_1","unstructured":"\u201cRegler for specialundervisning \u201dhttps:\/\/uvm.dk\/grundskole\/folkeskolen\/laering\u2010og\u2010laeringsmiljoe\/inklusion\u2010og\u2010specialundervisning\/specialundervisning\/regler\u2010for\u2010specialundervisning\/."},{"key":"e_1_2_12_25_1","first-page":"297","article-title":"Obstetric Factors and Different Causes of Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren. BJOG Int","volume":"120","author":"Mackay D. F.","year":"2013","journal-title":"Journal of Obstetrics and Gynaecology"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.3523"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"F34","DOI":"10.1136\/archdischild-2025-328599","article-title":"Effect of Gestational Age on Special Education: A Population\u2010Based Matched Cohort Analysis","volume":"111","author":"Baat T.","year":"2025","journal-title":"Archives of Disease in Childhood. Fetal and Neonatal Edition"},{"issue":"195","key":"e_1_2_12_28_1","first-page":"e1","article-title":"Long\u2010Term Outcomes After Neonatal Acidemia","volume":"233","author":"Zaigham M.","year":"2025","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.27604"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348409157136"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1987.15.4.340"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000445580.65983.d2"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2023.2284115"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70631","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70631","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:48:01Z","timestamp":1788882481000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/apa.70631"],"URL":"https:\/\/doi.org\/10.1111\/apa.70631","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"2025-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}