1. Markers of acute and chronic asphyxia in infants with meconium-stained amniotic fluid
- Author
-
Roger E. Bawdon, Jodie Roberts, Scott W. Roberts, Susan M. Ramin, Sherrie D. Richey, Jody Dax, and Larry C. Gilstrap
- Subjects
Adult ,Meconium ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Amniotic fluid ,Adolescent ,Gastroenterology ,Venous Cord Blood ,medicine.artery ,Internal medicine ,medicine ,Humans ,Erythropoietin ,reproductive and urinary physiology ,Meconium stained amniotic fluid ,Asphyxia ,Asphyxia Neonatorum ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,Umbilical artery ,Hydrogen-Ion Concentration ,Amniotic Fluid ,Fetal Blood ,Surgery ,Hypoxanthines ,Cord blood ,Acute Disease ,Chronic Disease ,Lactates ,Female ,medicine.symptom ,business ,Biomarkers ,medicine.drug - Abstract
OBJECTIVE: Cord blood pH, lactate, hypoxanthine, and erythropoietin levels has all been used as markers of either acute or chronic asphyxia. We sought to determine whether these index values were significantly different in infants with or without meconium-stained amniotic fluid. STUDY DESIGN: Fifty-six pregnant women in spontaneous labor at term were divided into two groups on the basis of the presence or absence of meconium-stained amniotic fluid. All meconium-stained fluid was centrifuged, and the volume percentage of particulate mater (i.e., meconium) was recorded. Umbilical artery blood and mixed arterial and venous cord blood were obtained at each delivery. Lactate, hypoxanthine, and erythropoietin levels were measured. Statistical analysis included Student t test and rank sum statistics where appropriate. Normal and Spearman correlation coefficients wer also used. RESULTS: There were no significant differences in mean umbilical artery pH 97.26 ± 0.06 vs 7.25 ± 0.10), lactate levels (32.8 ± 10 mg/dl vs 30.4 ± 14.2 mg/dl), and hypoxanthine levels (13.4 ± 6.7 μmol/L vs 14.0 ± 6.0 μmol/L) in newborns with meconium ( n = 28) compared with controls ( n = 26). Erythropoietin levels were significantly greater in newborns with meconium (median 39.5 mlU/ml vs 26.8 mlU/ml, p = 0.039). There was no correlation between the amount of particulate matter and any marker of asphyxia. CONCLUSIONS: There was no correlation between markers of acute asphyxia (i.e., umbilical artery blood pH, lactate, or hypoxanthine) and meconium. However, erythropoietin levels were significantly elevated in newborns with meconium-stained amniotic fluid. This latter marker may better correlate with chronic asphyxia.
- Published
- 1995