Abstract： Objective To explore the predictive value of umbilical artery blood gas analysis combined with ischemia-modified albumin(IMA)levels in umbilical artery blood on cardiac damage after mild asphyxia in neonates.Methods Sixty-eight neonates with mild asphyxia delivered in Funing People's Hospital from January 2022 to March 2023 were studied.A total of 65 cases were eligible.According to the occurrence of cardiac damage,they were assigned into non-cardiac damage group(n=39)and cardiac damage group(n=26).All cases underwent umbilical artery blood gas analysis at the delivery site.Umbilical artery blood samples were taken to determine the levels of IMA,creatine kinase isoenzyme(CK-MB)and high sensitivity troponin I(hsTnI).Data processing was performed by SPSS 25.0 software,and the receiver operating characteristic(ROC)curve was drawn.Results The Umbilical artery blood gas analysis indicators,including the pH value,partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),and residual base(BE),as well as lactic acid and biomarkers,including IMA,CK-MB,and hsTnI were significantly higher in the cardiac damage group than those of the non-cardiac damage group(P＜0.05).Multivariate Logistic regression analysis was carried out with cardiac damage(not applicable=0,applicable=1)as the dependent variable and the above indexes as covariables.The results showed that there were significant differences in pH,PO2 and IMA between groups(P＜0.05).IMA was moderately negatively correlated with pH and weakly negatively correlated with PO2.The area under ROC curve(AUC),cut-off value,sensitivity and specificity of pH value of umbilical artery blood gas to predict cardiac damage after mild asphyxia were 0.840,7.14,96.20％,and 64.10％,respectively.Those of IMA in umbilical artery blood were 0.893,79.65,73.10％and 89.70％,respectively.AUC,sensitivity and specificity of pH value of umbilical artery blood gas combined with IMA in umbilical artery blood to predict cardiac damage after mild asphyxia in neonates were 0.927,76.90％and 92.30％,respectively,which were better than the single detection.Conclusion pH value of umbilical artery blood gas combined with IMA in umbilical artery blood has a good predictive value for cardiac damage after mild asphyxia in neonates,and they are conveniently and rapidly measured.Their measurements can be considered as a clinical basis for early diagnosis of cardiac damage after mild asphyxia in neonates,showing a potential clinical application value.