RT Journal Article SR Electronic T1 Outcomes of extremely low birthweight infants with acidosis at birth JF Archives of Disease in Childhood - Fetal and Neonatal Edition JO Arch Dis Child Fetal Neonatal Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP F263 OP F268 DO 10.1136/archdischild-2013-304179 VO 99 IS 4 A1 David A Randolph A1 Tracy L Nolen A1 Namasivayam Ambalavanan A1 Waldemar A Carlo A1 Myriam Peralta-Carcelen A1 Abhik Das A1 Edward F Bell A1 Alexis S Davis A1 Abbot R Laptook A1 Barbara J Stoll A1 Seetha Shankaran A1 Rosemary D Higgins A1 on behalf of the Generic Database and Follow-Up Subcommittees for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network YR 2014 UL http://fn.bmj.com/content/99/4/F263.abstract AB Objectives To test the hypothesis that acidosis at birth is associated with the combined primary outcome of death or neurodevelopmental impairment (NDI) in extremely low birthweight (ELBW) infants, and to develop a predictive model of death/NDI exploring perinatal acidosis as a predictor variable. Study design The study population consisted of ELBW infants born between 2002 and 2007 at National Institute of Child Health and Development (NICHD) Neonatal Research Network hospitals. Infants with cord blood gas data and documentation of either mortality prior to discharge or 18–22 month neurodevelopmental outcomes were included. Multiple logistic regression analysis was used to determine the contribution of perinatal acidosis, defined as a cord blood gas with a pH<7 or base excess (BE) <−12, to death/NDI in ELBW infants. In addition, a multivariable model predicting death/NDI was developed. Results 3979 patients were identified of whom 249 had a cord gas pH<7 or BE<−12 mEq/L. 2124 patients (53%) had the primary outcome of death/NDI. After adjustment for confounding variables, pH<7 and BE<−12 mEq/L were each significantly associated with death/NDI (OR=2.5 (1.6, 4.2) and OR=1.5 (1.1, 2.0), respectively). However, inclusion of pH or BE did not improve the ability of the multivariable model to predict death/NDI. Conclusions Perinatal acidosis is significantly associated with death/NDI in ELBW infants. Perinatal acidosis is infrequent in ELBW infants, however, and other factors are more important in predicting death/NDI.