Prediction of short term clinical outcomes in low Apgar score neonates using umbilical artery blood gas analysis plus amplitude integrated electroencephalography
10.3760/cma.j.issn.2096-2932.2023.08.004
- VernacularTitle:脐血血气分析联合振幅整合脑电图监测与低Apgar评分患儿近期临床结局关系的研究
- Author:
Jiangbiao XIE
1
;
Xinzhu LIN
;
Zhuxin ZHANG
;
Lixia TANG
Author Information
1. 厦门大学附属妇女儿童医院（厦门市妇幼保健院）新生儿科，厦门市围产-新生儿感染重点实验室，厦门 361003
- Keywords:
Low Apgar score;
Umbilical artery blood gas;
Amplitude-integrated electroencephalography;
Neonatal asphyxia
- From:Chinese Journal of Neonatology
2023;38(8):465-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the predictive values of umbilical artery blood gas analysis(UABG) plus amplitude-integrated electroencephalography(aEEG) monitoring within 6 h after birth for early complications and short term neurological outcomes in low Apgar score neonates.Methods:From January 2020 to February 2022, neonates with gestational age (GA) ≥35 weeks and 1 min or 5 min Apgar score ≤7 admitted to NICU of our hospital were retrospectively reviewed. According to UABG pH values, the neonates were assigned into pH<7.2 group and pH ≥7.2 group, and further grouped into abnormal aEEG group and normal aEEG group. The ttest, rank sum test and χ2 test were used to compare laboratory results, incidences of diseases, physical growth and neurological prognosis at 6 month of age. Results:A total of 105 neonates with low Apgar scores were enrolled, including 73 cases in the pH<7.2 group and 32 cases in the pH≥7.2 group. In the pH<7.2 group, 52(71.2%) had abnormal aEEG and 21 had normal aEEG. In the pH≥7.2 group, 6(18.8%) had abnormal aEEG and 26 had normal aEEG. The incidence of abnormal aEEG in the pH<7.2 group was higher than the pH≥7.2 group ( P<0.001). The degree of aEEG abnormality was negatively correlated with UABG pH ( r=-0.463, P<0.001). In the pH<7.2 group, the levels of creatine kinase isozymes (CK-MB), activated partial thromboplastin time and the incidence of hypoxic-ischemic encephalopathy (HIE) in neonates with abnormal aEEG were significantly higher than those with normal aEEG, and the head circumference (HC) at 6 month was significantly smaller in neonates with abnormal aEEG (all P<0.05). In the pH≥7.2 group, the level of CK-MB, incidences of HIE and respiratory failure in neonates with abnormal aEEG were higher than those with normal aEEG, HC at 6 month was smaller and the incidence of adverse neurological prognosis was higher in neonates with abnormal aEEG (all P<0.05). Conclusions:UABG plus aEEG monitoring within 6 h after birth shows predictive values for early complications and short term neurological outcomes in low Apgar scores neonates.
