{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:10:55Z","timestamp":1788311455604,"version":"build-2803163510"},"reference-count":15,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This retrospective cohort study aimed to identify perinatal factors associated with umbilical arterial pH in term neonates delivered via cesarean section, using a pH cutoff of 7.20 to define neonatal acidosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed clinical data from 356 mother\u2013neonate dyads who underwent cesarean delivery at a tertiary hospital between January 2020 and December 2022. Neonates were categorized into two groups based on umbilical arterial pH values (&lt;7.20 vs. \u22657.20). We evaluated maternal and intrapartum factors, including amniotic fluid quality (operationally defined as clear or meconium-stained (grades I\u2013III)), duration of labor, and fetal distress. Statistical analyses included multivariable logistic regression to quantify associations (reported as odds ratios with 95% confidence intervals) and random forest modeling to identify key predictors. Model performance was assessed via receiver operating characteristic curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of acidosis (umbilical arterial pH &lt;7.20) was 51.0% (52\/102). Meconium-stained amniotic fluid (adjusted odds ratio: 3.12; 95% confidence interval: 1.75\u20135.58; p\u2009&lt;\u20090.001) and trial of labor (adjusted odds ratio: 2.45; 95% confidence interval: 1.40\u20134.30; p\u2009=\u20090.002) were significantly associated with acidosis. The random forest model identified these factors as the top predictors, with an area under the curve of 0.71 (95% confidence interval: 0.68\u20130.74) based on 10-fold cross-validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Meconium-stained amniotic fluid and prolonged labor are strongly associated with acidosis in term cesarean deliveries. Early identification of these factors may aid in risk stratification and perinatal management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605251390721","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T05:28:12Z","timestamp":1763184492000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with umbilical arterial blood pH in term neonates delivered via cesarean section: A retrospective cohort study"],"prefix":"10.1177","volume":"53","author":[{"given":"Linlin","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7970-321X","authenticated-orcid":false,"given":"Mingming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Women\u2019s Hospital of Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youdi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_3_10_2_2","first-page":"401","article-title":"Chinese Society of Perinatal Medicine. Expert consensus on clinical application of umbilical arterial blood gas analysis in neonates","volume":"24","author":"Neonatal Resuscitation Group.","year":"2021","unstructured":"Neonatal Resuscitation Group. Chinese Society of Perinatal Medicine. Expert consensus on clinical application of umbilical arterial blood gas analysis in neonates. Chinese Journal of Perinatal Medicine 2021; 24: 401\u2013405.","journal-title":"Chinese Journal of Perinatal Medicine"},{"key":"e_1_3_10_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200611000-00058"},{"key":"e_1_3_10_4_2","first-page":"100","article-title":"Relationship between umbilical artery hemodynamics and blood lactate with fetal hypoxia and oxidative stress levels in intrauterine distress","volume":"51","author":"Liping L","year":"2023","unstructured":"Liping L, Meiling Z, , andHuijing W. Relationship between umbilical artery hemodynamics and blood lactate with fetal hypoxia and oxidative stress levels in intrauterine distress. Journal of Central South Medical Sciences 2023; 51: 100\u2013102.","journal-title":"Journal of Central South Medical Sciences"},{"key":"e_1_3_10_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_10_6_2","first-page":"159","article-title":"[Predictive value of umbilical arterial cord pH on complications during hospitalization in neonates after cesarean section]","volume":"51","author":"Bao J","year":"2019","unstructured":"Bao J, Liu J, Qu Y, et\u00a0al. [Predictive value of umbilical arterial cord pH on complications during hospitalization in neonates after cesarean section]. Beijing Da Xue Xue Bao Yi Xue Ban 2019; 51: 159\u2013164.","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban"},{"key":"e_1_3_10_7_2","first-page":"415","article-title":"Correlation between umbilical artery blood pH and Apgar score, perinatal factors, and early neonatal outcomes","volume":"23","author":"Qingqing W","year":"2020","unstructured":"Qingqing W, Meihua P, Tongyan H, et\u00a0al. Correlation between umbilical artery blood pH and Apgar score, perinatal factors, and early neonatal outcomes. Chinese Journal of Perinatal Medicine 2020; 23: 415\u2013419.","journal-title":"Chinese Journal of Perinatal Medicine"},{"key":"e_1_3_10_8_2","first-page":"74","article-title":"Correlation analysis of gestational age, delivery mode, and neonatal umbilical artery blood gas abnormalities","volume":"36","author":"Yumei G.","year":"2019","unstructured":"Yumei G. Correlation analysis of gestational age, delivery mode, and neonatal umbilical artery blood gas abnormalities. Journal of Hubei University for Nationalities (Medical Edition) 2019; 36: 74\u201375.","journal-title":"Journal of Hubei University for Nationalities (Medical Edition)"},{"key":"e_1_3_10_9_2","first-page":"1385","article-title":"Predictive value of umbilical arterial blood gas analysis for brain injury in neonates after asphyxia resuscitation","volume":"30","author":"Siying Z","year":"2022","unstructured":"Siying Z, Ziyi H. Predictive value of umbilical arterial blood gas analysis for brain injury in neonates after asphyxia resuscitation. Chinese Journal of Eugenics and Genetics 2022; 30: 1385\u20131390.","journal-title":"Chinese Journal of Eugenics and Genetics"},{"key":"e_1_3_10_10_2","first-page":"230","article-title":"Meconium aspiration syndrome: a narrative review","volume":"8","author":"Monfredini C","year":"2021","unstructured":"Monfredini C, Cavallin F, Villani PE, et\u00a0al. Meconium aspiration syndrome: a narrative review. 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