[Severe peripartum acidosis of the mature newborn infant (umbilical artery pH less than or equal to 7.00)--early morbidity and early growth].

Early morbidity and neurological development in 40 term infants with UApH less than or equal to 7,00 (6,60-7,00) were investigated. Group 1: 18 infants (45%) responded well to the measures of primary resuscitation--they never revealed any neurological symptoms and their growth and development were normal. Group 2: 15 infants (37,5%) who responded less well to primary resuscitation initially had mild to moderate neurological symptoms subsiding during the first few days of life. There were 2 cases of necrotizing enterocolitis and 4 cases of moderate meconium aspiration syndrome. Apgar scores, pH and blood-gases were worse than in group 1. At discharge and on follow-up all children appeared clinically normal. Group 3: 7 infants (17,5%) with severe neurological signs were not responding well to resuscitation. They were referred to the intensive care nursery and treated for cerebral edema (hyperventilation, pentobarbital, steroids). 2 infants with severe meconium aspiration syndrome recovered entirely. Two children had evidence of cerebral involvement as demonstrated by means of computerized tomography of the head, but were normal on follow-up. Three children with distinct signs of cerebral palsy developed cerebral atrophy and microcephaly, presumably due to hypoxic-ischemic encephalopathy. Early morbidity, comprising all 22 infants from group 2 and 3 amounts to 55%, morbidity up to an average age of 14,7 month includes 5 infants from group 3 (suspected cerebral lesions in 2, microcephalus in 3) and thus comes to 12,5% of the total.