The Comparison of Umbilical Cord Arterial Blood Lactate and pH Values for Predicting Short-Term Neonatal Outcomes

Comparativa entre los Valores de Lactato en Sangre Arterial del Cordón Umbilical y el pH para Predecir los Resultados Neonatales a Corto Plazo

Nowadays the clinical practice of evaluating neonatal condition is established by assessing the umbilical cord arterial blood pH value instead of lactate. Nonetheless, evidence shows that lactate is a more prognostic measurement than pH or at least of comparable relevance. This study aims to assess and compare umbilical cord arterial lactate and pH values for predicting short-term neonatal outcomes.

This retrospective cohort study was carried out at a tertiary referral centre in Lithuania from 1 January 2015 to 31 March 2015. Health workers collectd umbilical cord arterial blood according to the standard procedure: from double-clamped cord segments after neonatal delivery. Blood gases and lactate were measured using automated analyser (ABL90 FLEX Radiometer). In total, 936 births were registered during the study period.

Neonatal morbidity was registered if at least one of the following conditions was noted: Apgar score 1 minute after delivery was 6 or lower, resuscitation performed, including assisted ventilation and requirement of admission to neonatal ICU. Mothers-newborns pairs were allocated into two groups: newborns exposed to perinatal hypoxia (group 1) and observed as healthy newborns (group 2). Receiver operating characteristics curves (ROC) were generated to assess the predictive ability of pH and lactate for the short-term neonatal outcomes.

Umbilical cord arterial blood gas is a valuable tool for determining impaired neonatal condition. In current clinical practice pH is used more often than lactate, although lactate has the advantage of requiring less blood and simpler equipment.

The authors concluded that umbilical cord arterial lactate and pH predicted short-term neonatal outcomes with similar efficacies.

This study was completed by Ruta Einikyte, Vilija Snieckuviene, Diana Ramasauskaite,  Jurate Panaviene, Virginija Paliulyte, Gina Opolskiene and Edita Kazenaite, and it was published in 2017 by Taiwanese Journal of Obstetrics & Gynecology 56 (2017) 745-749


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The Comparison of Umbilical Cord Arterial Blood Lactate and pH Values for Predicting Short-Term Neonatal Outcomes