Acidaemia at Birth: Risk factors, diagnosis and prognosis, with special reference to maternal fever in labour

Abstract: Acidaemia at birth is a result of an impaired intrauterine gas exchange. Between 1988 and 1996, acid-base balance in cord artery blood pH was assessed in 23 016 of 27 064 newborns (85%). Obstetric risk factors for acidaemia (cord artery pH < 7.05) were identified in a case-control study. Independent risk factors were breech delivery, administration of oxytocin or pethidine, cord entanglement and male gender. In a matched-pair study, factors associated with the development of maternal fever during term labour were identified: epidural analgesia, long interval between rupture of the membranes and delivery, and long latency phase of labour. Maternal fever during term labour was associated with neonatal infectious morbidity, but not with newborn acidaemia. Two regimens for fetal surveillance in low-risk labour were compared in a randomised study; continuous and intermittent electronic fetal monitoring with two-hour intervals. No significant differences were found in rates of detected abnormal fet