Two-year outcomes for infants with low cord pH at birth

Objective: To determine the long-term outcome of infants born with cord pH ≤7.0 and no clinical evidence of asphyxia at birth. Design: Setting: Tertiary Referral Centre. A prospective matched cohort study was conducted. 51 term infants were recruited following singleton birth with venous cord pH ≤7.0.For each recruited baby a healthy baby with normal cord pH >7.20 was recruited matched for gestation, gender and mode of delivery. Ages and Stages Questionnaires (ASQ)TM and Health Screening Questionnaires (HSQ) were sent out at 24 months of age. Two independent assessors, blinded to the case assignment, reviewed intrapartum and neonatal events to look for clinical evidence of birth asphyxia among the cases. Result: From 102 infants recruited, 62 questionnaires (24 cases, 38 controls) were returned. 20 matched pairs with no clinical evidence of birth asphyxia were available for analysis. The groups were similar except in terms of birth weight; the pH<7.0 group had mean birth weight 584g lower than controls (p=0.005). The ASQ motor scores were lower in children born with low cord pH (p=0.019), however, once adjusted for birth weight, the difference was not significant (p=0.289). Conclusion: It is unlikely that abnormal cord pH in otherwise healthy neonates leads to a substantially increased risk of abnormal neurodevelopmental outcome or severe health problems by 2 years of age.