Cord Blood Lactate and pH Values at Term and Perinatal Outcome: A Retrospective Cohort Study
نویسنده
چکیده
Objective: To examine the relationship between newborn umbilical cord blood lactate and pH levels, mode of delivery and short-term neonatal outcome. Materials and methods: Umbilical cord arterial and venous lactate and pH values, mode of delivery, birth weight, gestational age, Apgar scores were extracted from the Obstetrix database at Nepean Hospital in Sydney. More than 7400 newborn cord blood gases were available for analysis. Results: Gestational age ranged from 37 to 43 weeks (mean 39.7 weeks). The highest mean arterial cord lactate values were noted among babies delivered instrumentally (5.1 mmol/L). Infants who had a normal vaginal delivery had the second highest levels (4.3mmol/L), followed by infants delivered by emergency caesarean section (3.9 mmol/L). The lowest lactate values were noted in deliveries by elective caesarean section (3.2 mmol/L). Cord arterial lactate levels were significantly higher among infants born with low Apgar scores (7.02 mmol/L vs 4.0 mmol/L, P < 0.001). Newborns with raised cord arterial lactate were significant more likely to have low Apgar scores (OR 4.8, 2.4-9.9), whereas low arterial cord pH was slightly less significant (OR = 3.6). High arterial cord lactate was a significant predictor of admission to NICU (OR 2.9, 2.1 – 4.1). ROC analysis suggests that lactate and pH are virtually equivalent in their correlation with adverse neonatal outcome. Conclusions: Cord lactate and pH levels are significantly related to the mode of delivery. Cord arterial lactate is equivalent to cord arterial pH in predicting adverse neonatal outcomes, with limited sensitivity and specificity.
منابع مشابه
Cord blood lactate and pH values at term and perinatal outcome: a retrospective cohort study
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