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Catecholamine levels and associated cardiovascular responses in infants with meconium-stained amniotic fluid

  • Neonatology
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Abstract

Catecholamine levels and associated cardiovascular responses were determined in 21 control and 30 term infants with meconium-stained amniotic fluid (MSAF). Cord arterial blood was obtained for determination for norepinephrine (NE) and epinephrine (EPI) levels; cardiovascular measurements included heart rate and systolic blood pressure at 30 min. Pregnancy was uncomplicated in all cases. The total length of labor 964±402 versus 555±312 min (P<0.001) and active phase of labor 300±261 versus 135±104 min (P<0.001) were significantly longer in MSAF infants when compared to controls. The 1 min Apgar score was <7 (range 1–6) in 11 of 30 MSAF infants versus 0 of 21 control infants; these 11 infants required positive pressure ventilation for approximately 60 s secondary to transient respiratory depression (RD). The 5 min Apgar score was >7 in 49 of the 51 infants. Infants with MSAF exhibited a higherP aCO2 (6.89±1.17 vs 6.24±1.17 mm Hg;P<0.02) and lower pH (7.25±0.06 vs 7.29±0.05;P<0.02) compared to controls. Infants with transient RD demonstrated the most marked arterial blood gas differences, i.e.,PCO2 7.41±1.30 mm Hg (P<0.001), pH 7.21±0.07 (P<0.001) and base deficit −6±4 versus −3±2.8 (P<0.001) when compared to controls. NE and EPI levels were significantly higher in MSAF versus control infants, i.e., 12600±3040 versus 3740±1000 pg/ml (SEM) (P<0.02) and 1550±250 versus 620±130 pg/ml (P<0.001) respectively. The highest values were observed in infants with transient RD. NE levels were related to base deficit (r=−0.45,P<0.0001) and the presence of meconium (r=0.26,P<0.05), while EPI levels were related to pH (r=0.44,P<0.001) and meconium (r=0.28,P<0.05). MSAF infants exhibited a higher systolic blood pressure at 30 min, i.e., 59±10 versus 54±8 mm HgP<0.002 when compared to controls. No differences in heart and respiratory rates were noted. These data indicate that infants delivered in the presence of MSAF exhibit significant elevations in catcholamine levels when compared to control infants, which may reflect an adaptive respone to in utero stress.

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Authors and Affiliations

  1. Department of Pediatrics, Washington University School of Medicine, 63110, St. Louis, MO, USA

    A. Garcia-Alix & J. M. Perlman

  2. Department of Obstetrics and Gynecology, Washington University School of Medicine, 63110, St. Louis, MO, USA

    E. Amon

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  1. A. Garcia-Alix
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  2. J. M. Perlman
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  3. E. Amon
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Garcia-Alix, A., Perlman, J.M. & Amon, E. Catecholamine levels and associated cardiovascular responses in infants with meconium-stained amniotic fluid. Eur J Pediatr 151, 855–860 (1992). https://doi.org/10.1007/BF01957940

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  • DOI: https://doi.org/10.1007/BF01957940

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