Correlation of Metabolic Acidosis in Neonate with Morbidity, Mortality and Neurodevelopmental Outcome.

Metabolic Acidosis in Neonate

Abstract

Background: In metabolic acidosis there is risk of neonatal encephalopathy with symptoms varying from lethargy to coma. The neonates with encephalopathy usually present with decreased level of consciousness with abnormality in neuromotor tone and associated with seizure like activity, hypoventilation or apnea. Subjects and Methods: In the present study the children were followed upto 9 months of age and assessment of neurodevelopment was done and the correlation of acidosis with neurodevelopment outcome was analyzed. Results: Of 100 neonates with metabolic acidosis, 26 babies had necrotizing enterocolitis, 20 had seizures, 15 had intraventricular/periventricular hemorrhage and 33 babies had renal dysfunction. Out of 100 neonates with metabolic acidosis, 10 babies died and 23 had good outcome. There exists correlation between pH and neurodevelopmental outcome. The p value is 0.000 i.e it is significant. Thus with decreasing pH, there is increased incidence of neurodevelopmental delay. The incidence of developmental delay is more in neonates with pH <7.20, 4 (21.1%) babies had transient abnormalities, 2 (10.5%) had persistent abnormalities. There exists correlation between base deficit and neurodevelopmental outcome. The p value is 0.000 i.e it is significant. Thus with increasing base deficit, there is increased incidence of neurodevelopmental delay. Conclusion: With based deficit of >12 mmol/l, there is increased incidence of neurodevelopmental delay i.e 25% had persistent abnormality and 10% transient abnormality hence it can be used as one of the early predictors of neurodevelopmental delay.