Is Umbilical Cord Arterial Lactate a Predictive Indicator for Assessment of in-Term Neonates Well-being?
1Erciyes Unıversity, Kayseri, Department of Pediatric, Turkey
2Yozgat Bozok University, Faculty of Health Science, Turkey
J Clin Pract Res 2022; 44(1): 88-94 DOI: 10.14744/etd.2021.56659
Full Text PDF

Abstract

Objective: This study was conducted as a medical records-based retrospective design to determine whether lactate is a predictive indicator for predicting well-being and the severe conditions of neonates.
Materials and Methods: The sampling of the study consists of 81 term neonates whose gestation age is 37 weeks and above, and monitored in the neonate intense care unit, whose cord arterial blood gas was taken during the birth and had respiratory distress. The data were retrospectively collected from the neonates’ file records.
Results: Umbilical cord arterial lactate value was found associated with pH and Apgar score for assessment of the well-being of neonates and suggested it predict the low Apgar score. (p<0.05). The lactate value was significantly higher at birth in neonates with Meconium Aspiration Syndrome (MAS) and Premature Rupture of Membranes (PROM) according to pH and other cord gas parameters. ROC curve analysis was used to determine whether lactate and pH were predictive indicators of the first-minute Apgar score and lactate was found more distinguishing than pH. Additionally, it was determined that as the lactate level increased, the duration of hospitalization increased.
Conclusion: Cord lactate is at least as predictive as Apgar scores and pH for determining severe conditions. Lactate might be useful for clinicians at first-level hospitals for decision- making to refer the patient to the secondary or tertiary level neonatal intensive care unit before the clinical situation is worsened.