Hydration and pH of Cord and Dorsal Hand in High-Risk Infants for 7 Days of Life

Thursday, 2 August 2012: 8:50 AM

Youngmee Ahn, PhD, RN
Min Sohn, PhD, RN
Mijin Lee, BS
Sangmi Lee
Department of Nursing, Inha University, Incheon, South Korea

Learning Objective 1: The learner will be able to understand the body of knowledge on pH and hydration of cord and skin of high-risk neonates.

Learning Objective 2: The learner will be able to understand the pH and hydration factors in cord and skin care of high-risk infants in terms of infection control.

Purpose: The pH of cord and skin is of significance in terms of the acidic function of skin in defending foreign invasions while drying process toward cord detachment. We explored the pH and hydration in cord and dorsal hand of 50 high-risk neonates for 7 days of life. Fourteen neonates were with primarily preterm birth (PTB), while 36 neonates had pathologic conditions besides PTB. The mean birth weight was 1973 g with 7.4 of the mean 5 min. Apgar score.

Methods: After IRB approval and obtaining the informed consent from parents, the pH and hydration of cord and dorsal hand of neonates was measured at 1st, 2nd, 3rd, 5th and 7th day of life using ph meter (HI 99181, HANNA) and hydration meter (National DM-R2, Japan). 

Results: The results showed the significant changes in pH (F=199.662, p<.001) and hydration (F=9.460, p=.002) between two sites. The patterns of the changes in pH between two sites significantly differ across 7 days for pH (F=8.804, p<.001), while no interaction in changes in hydration between sites and 7 days of life (F=0.878, p=.478). Small positive relationships were observed in cord (r=.196) and hand (r=.098) between pH and gestation while fairly moderate negative relationships in cord (r=-.330) and hand (r=-.436) between hydration and gestation in high-risk neonates.

Conclusion: The formation of acid mantle at both cord and skin may take more than 7 days of life for high-risk infants. Hydration level differs between cord and skin whil little changes on hydration itself for 7 days per each site.  Further analysis is needed to explore the factors on pH and hydration of cord and skin in respect to cord detachment and cord care.