Physiological development of a mixed metabolic and respiratory umbilical cord blood acidemia with advancing gestational age

Wiberg, Nana; Källén, Karin; Olofsson, Per

doi:10.1016/j.earlhumdev.2005.12.005

Cited by 31 publications

(32 citation statements)

References 12 publications

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“…Statistical analyses were performed with the aid of STATVIEW â (SAS Institute, Cary, NC, USA). As umbilical cord blood gas and lactate values are dependent on gestational age, [10][11][12] comparisons between groups delivered vaginally and by caesarean section were also performed using cord arterial pH adjusted to a gestational age of 280 days, according to the regression coefficient À0.00096 per day of gestational age. 10 …”

Section: Statistical Analysesmentioning

confidence: 99%

Hidden acidosis: an explanation of acid–base and lactate changes occurring in umbilical cord blood after delayed sampling

Mokarami

Wiberg

Olofsson

2013

BJOG

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Objective To explore the 'hidden acidosis' phenomenon, in which there is a washout of acid metabolites from peripheral tissues in both vaginal and abdominal deliveries, by investigating temporal umbilical cord blood acid-base and lactate changes after delayed blood sampling.Design Prospective comparative study.Setting University hospital.Sample Umbilical cord blood from 124 newborns.Methods Arterial and venous cord blood was sampled immediately after birth (T 0 ), and at 45 seconds (T 45 ), from unclamped cords with intact pulsations taken from 66 neonates born vaginally and 58 neonates born via planned caesarean section at 36-42 weeks of gestation. Non-parametric tests were used for statistical comparisons, with P < 0.05 considered significant.Main outcome measures Temporal changes (T 0 -T 45 ) in umbilical cord blood pH, the partial pressure of CO 2 (P CO 2 ) and O 2 (P O 2 ), and in the concentrations of lactate, haematocrit (Hct), and haemoglobin (Hb).Results In both groups all arterial parameters, except for P CO 2 in the group delivered by caesarean section, changed significantly (pH decreased and the other variables increased). There were corresponding changes in venous acid-base parameters. When temporal arterial changes were compared between the two groups, the decrease in pH and increase in P CO 2 were more pronounced in the group delivered vaginally. Neonates born vaginally had significantly lower pH and higher lactate, Hct, and Hb concentrations at T 0 and T 45 in both the artery and the vein. At T 45 , arterial P CO 2 and P O 2 levels in the group delivered vaginally were also significantly higher.Conclusions Delayed umbilical cord sampling affected the acidbase balance and haematological parameters after both vaginal and caesarean deliveries, although the effect was more marked in the group delivered vaginally. The hidden acidosis phenomenon explains this change towards acidaemia and lactaemia. Arterial haemoconcentration was not the explanation of the acid-base drift.

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Section: Statistical Analysesmentioning

confidence: 99%

Hidden acidosis: an explanation of acid–base and lactate changes occurring in umbilical cord blood after delayed sampling

Mokarami

Wiberg

Olofsson

2013

BJOG

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“…Generally, PO 2 reduction in the blood is the predominant stimulus for up-regulation of EPO gene expression [29, 32]. However, the increase in PCO 2 , which is caused by an increase in the CO 2 load due to the growing fetus [33], diminishes the oxygen affinity of hemoglobin by the Bohr effect, and this results in increasing peripheral oxygenation, thereby reducing the signal for EPO formation [28, 34–37]. Since EPO is required for the survival and radioprotection of committed erythrocyte progenitor cells [38, 39], it is speculated that the radiosensitivity of BFU-E is dependent on the increase in fetal PCO 2 and HCO 3 − levels, which involve fetal EPO levels.…”

Section: Discussionmentioning

confidence: 99%

Involvement of placental/umbilical cord blood acid-base status and gas values on the radiosensitivity of human fetal/neonatal hematopoietic stem/progenitor cells

Yamaguchi

Ebina

Kashiwakura

2012

Journal of Radiation Research

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Arterial cord blood (CB) acid–base status and gas values, such as pH, PCO2, PO2, HCO3−and base excess, provide useful information on the fetal and neonatal condition. However, it remains unknown whether these values affect the radiosensitivity of fetal/neonatal hematopoiesis. The present study evaluated the relationship between arterial CB acid–base status, gas values, and the radiosensitivity of CB hematopoietic stem/progenitor cells (HSPCs). A total of 25 CB units were collected. The arterial CB acid–base status and gas values were measured within 30 min of delivery. The CD34+HSPCs obtained from CB were exposed to 2 Gy X-irradiation, and then assayed for colony-forming unit-granulocyte-macrophage, burst-forming unit-erythroid (BFU-E), and colony-forming unit-granulocyte erythroid, macrophage and megakaryocyte cells. Acid–base status and gas values for PCO2and HCO3−showed a statistically significant negative correlation with the surviving fraction of BFU-E. In addition, a significant positive correlation was observed between gestational age and PCO2. Moreover, the surviving fraction of BFU-E showed a significant negative correlation with gestational age. Thus, HSPCs obtained from CB with high PCO2/HCO3−levels were sensitive to X-irradiation, which suggests that the status of arterial PCO2/HCO3−influences the radiosensitivity of fetal/neonatal hematopoiesis, especially erythropoiesis.

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“…As parturition progresses, a mixed acidosis develops and there is a significant increase in foetal CO 2 production (Wiberg et al, 2006). Under hypoxic conditions, tissue acidosis occurs earlier than blood acidosis (Abitbol et al, 1986).…”

Section: Asphyxia and Acidosismentioning

confidence: 99%

Physiological events during parturition and possibilities for improving puppy survival: a review

Kredatusova¹,

Hajurka²,

Szakallova³

et al. 2011

Vet. Med. - Czech

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Physiological development of a mixed metabolic and respiratory umbilical cord blood acidemia with advancing gestational age

Cited by 31 publications

References 12 publications

Hidden acidosis: an explanation of acid–base and lactate changes occurring in umbilical cord blood after delayed sampling

Hidden acidosis: an explanation of acid–base and lactate changes occurring in umbilical cord blood after delayed sampling

Involvement of placental/umbilical cord blood acid-base status and gas values on the radiosensitivity of human fetal/neonatal hematopoietic stem/progenitor cells

Physiological events during parturition and possibilities for improving puppy survival: a review

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