早产儿出生12h内动脉血pH与其早期结局的相关性OA

Objective To analyze the correlation between arterial blood pH within 12 hours after birth and the early outcomes of preterm infants.Methods This was a retrospective study of 2 593 premature infants hospitalized at Department of Neonatology Xinjiang Uygur Autonomous Region People's Hospital between January 2014 and December 2024.According to the arterial blood pH within 12 hours after birth,the subjects were divided into two groups:the pH<7.2 group(n=390)and the pH≥7.2 group(n=2 203).The occurrence of early complications such as death within one week,shock within one week,neonatal respiratory distress syndrome,early-onset sepsis,and intraventricular hemorrhage≥grade Ⅲ among the groups were compared.The multivariate Logistic regression analysis was conducted to investigate the impact of acidosis on the early adverse outcomes of premature infants.The receiver operating characteristic curve was used to analyze the value of arterial blood pH within 12 hours after birth in predicting the occurrence of early adverse outcomes of premature infants.Statistical analysis was performed by independent samples t-test,Mann-Whitney U test and χ2 test.Results Compared with the pH≥7.2 group,the gestational age and birth weight of the pH<7.2 group were lower,the proportions of outborn and 5-minute Apgar score≤7 points of the pH<7.2 group were higher,the differences were statistically significant(all P<0.001);the incidence of death within one week,shock within one week,neonatal respiratory distress syndrome,and early-onset sepsis were higher in the pH<7.2 group[6.15%(24/390)vs 0.91%(20/2 203),5.90%(23/390)vs 1.00%(22/2 203),44.36%(173/390)vs 14.57%(321/2 203),24.87%(97/390)vs 8.26%(182/2 203),χ2 values were 54.666,46.628,190.644,95.207,respectively,all P<0.001];the incidence of intraventricular hemorrhage≥grade Ⅲ was higher in the pH<7.2 group[1.79%(7/390)vs 0.59%(13/2 203),χ2=4.808,P=0.028].The results of multivariate Logistic regression analysis showed that the arterial blood pH<7.2 in premature infants within 12 hours after birth was an independent risk factor for death within one week(OR=3.256,95%CI:1.675-6.330,P=0.001)and shock within one week(OR=2.950,95%CI:1.557-5.588,P=0.001).The results of the ROC curve analysis showed that the cut-off value of arterial blood pH within 12 hours after birth for predicting the death of premature infants within one week was 7.239,with a sensitivity of 72.7%,a specificity of 75.8%,and an area under the curve of 0.808(95%CI:0.739-0.877,P<0.001).Conclusion The arterial blood pH of premature infants within 12 hours after birth has a certain correlation with their early complications and adverse outcomes.Utilizing the arterial blood pH to predict the early adverse outcomes of premature infants has certain clinical value.