{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:44:53Z","timestamp":1782866693311,"version":"3.54.5"},"reference-count":32,"publisher":"Korean Pediatric Society","issue":"7","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS-2025-02220492"],"award-info":[{"award-number":["RS-2025-02220492"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["2025-ER0601-00#"],"award-info":[{"award-number":["2025-ER0601-00#"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:p>Background: The impact of metabolic acidosis on short-term outcomes and mortality in very low birth weight infants (VLBWIs) has not been well studied.Purpose: To investigate the potential association between metabolic acidosis and the clinical outcomes of VLBWIs in South Korea.Methods: Between 2013 and 2019, data were collected from the Korean Neonatal Network, which covers a multicenter birth cohort spanning 75 hospitals. Our study cohort included 14,519 infants with a birth weight of less than 1,500 g who were admitted to the neonatal intensive care unit. Blood gas measurements taken within 1 hour of birth were used to evaluate the clinical outcomes, which were categorized into 5 groups according to base excess (BE) levels. We assessed respiratory outcomes, neurological morbidities, and infection-related and gastrointestinal outcomes along with mortality rates.Results: We analyzed 10,394 VLBWIs based on the inclusion criteria. A BE level below -9 suggested a significantly high risk of various respiratory outcomes, including air leak syndrome (adjusted odds ratio [aOR], 2.071; 95% confidence interval [CI], 1.305\u20133.285), massive pulmonary hemorrhage (aOR, 2.317; 95% CI, 1.502\u20133.575), pulmonary hypertension (aOR, 2.296; 95% CI, 1.667\u20133.161), and neonatal respiratory distress syndrome (aOR, 2.219; 95% CI, 1.778\u20132.769). These infants also exhibited an elevated risk of neurological (aOR, 2.797; 95% CI, 2.314\u20133.380), infection-related (aOR, 2.082; 95% CI, 1.653\u20132.623), gastrointestinal (aOR, 1.979; 95% CI, 1.408\u20132.783), and mortality (aOR, 2.683; 95% CI, 2.076\u20133.466) outcomes.Conclusion: Our findings highlight the potential effect of metabolic acidosis at birth on the clinical outcomes of VLBWIs. A strong correlation was observed between metabolic acidosis and neurological morbidity. These findings offer important insights for managing VLBWIs with metabolic acidosis and suggest the need for future research on acid-base balance risk factors.<\/jats:p>","DOI":"10.3345\/cep.2025.02817","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:55:13Z","timestamp":1779353713000},"page":"555-562","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between base excess levels and clinical outcomes among very low birth weight infants: a multicenter birth cohort study in South Korea"],"prefix":"10.3345","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7154-4629","authenticated-orcid":true,"given":"Ji Yoo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1286-4669","authenticated-orcid":true,"given":"Hyeon Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea"},{"name":"Department of Precision Medicine, Kyung Hee University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0513-0618","authenticated-orcid":true,"given":"Heeyoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0293-0570","authenticated-orcid":true,"given":"Minji","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8580-490X","authenticated-orcid":true,"given":"Jinseok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Kyung Hee University, Yongin, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-7849","authenticated-orcid":true,"given":"Yong Sung","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-9948","authenticated-orcid":true,"given":"Dong Keon","family":"Yon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea"},{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea"},{"name":"Department of Precision Medicine, Kyung Hee University, Seoul, Korea"},{"name":"Department of Biomedical Engineering, Kyung Hee University, Yongin, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.22249","type":"journal-article"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-023-02814-9","type":"journal-article"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075060","type":"journal-article"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-022-01303-9","type":"journal-article"},{"key":"ref5","volume-title":"","author":"Behrman","year":"2007","type":"book"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)00878-4","type":"journal-article"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-225053","type":"journal-article"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-241570","type":"journal-article"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-014-2364-9","type":"journal-article"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e162","type":"journal-article"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2196\/47612","type":"journal-article"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e263","type":"journal-article"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-09053-8","type":"journal-article"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.54724\/lc.2022.e3","type":"journal-article"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1110891","type":"journal-article"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2017040422","type":"journal-article"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1471","type":"journal-article"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-023-06084-9","type":"journal-article"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14925","type":"journal-article"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3091","type":"journal-article"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-04207-7","type":"journal-article"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-019-0706-y","type":"journal-article"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.7.2.182","type":"journal-article"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1226068","type":"journal-article"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/01.aoa.0000927780.86660.b4","type":"journal-article"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304179","type":"journal-article"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.123204","type":"journal-article"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2005.12.005","type":"journal-article"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-41516-y","type":"journal-article"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1197607","type":"journal-article"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-04135-6","type":"journal-article"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186936","type":"journal-article"}],"container-title":["Clinical 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