Prediction Of Respiratory Morbidities In Neonates Using Cord Blood Arterial Lactate And Base Excess

Main Article Content

Aditi D Bakare
J.M Pawar
K.Mahendranath
Shreshta.B.R
Subhangi Misal

Keywords

Respiratory, Lactate, Prediction, blood

Abstract

Background: The umbilical blood gas analysis is a valid tool for the evaluation of neonatal acidemia. Knowledge of the fetal acid-base status and detection of acidemia at the time of delivery can serve as a sensitive and accurate component in the assessment of a neonate’s risk of morbidity and death.
Aims and Objectives: To assess the correlation between cord blood arterial lactate levels, base excess in neonates and the development of respiratory distress and the requirement of delivery room resuscitation. To assess whether umbilical cord arterial lactate is superior to pH for predicting short-term neonatal morbidity.
Material and Methods: Study design: hospital based observational study. Sample size:138. Study setting: Labor ward of Krishna Hospital, Karad. Study period: January 2021 to November 2022.Data analysis: SPSS software using relevant statistical method.
Results: 138 neonates were enrolled. Cord blood base excess levels were higher in neonates with respiratory distress and those requiring delivery room resuscitation. However, there was no significant association between cord blood lactate levels and outcomes assessed
Conclusion: Estimation of arterial base excess levels obtained from umbilical cord blood sampling during delivery may serve as a sensitive marker for predicting respiratory morbidities.

Abstract 87 | PDF Downloads 149

References

1. Tasnim N, Mahmud G, Akram S. Predictive accuracy of intrapartum cardiotocography in terms of fetal acid base status at birth. J Coll Physicians Surg Pak. 2009;19(10):632-5.
2. Malin GL, Morris RK, Khan KS. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. Bmj. 2010 May 13;340.
3. Umbilical cord blood gas and acid-base analysis.
ACOG Committee Opinion No. 348. American College of Obstetricians and Gynecologists. Obstet Gynecol 2006;108:1319–22.
4. Uzan S, Berkane N, Verstraete L, Mathieu E, Bréart G. Acid base balance in the fetus during labor: pathophysiology and exploration methods [in French]. J Gynecol Obstet Biol Reprod (Paris) 2003;32(suppl):1S68–78.
5. Thorp JA, Dildy GA, Yeomans ER, et al. Umbilical cord blood gas analysis at delivery.Am J Obstet Gynecol 1996;175:517-22.
6. Yeh P, Emary K, Impey L. The relationship between umbilical cord arterial pH and serious adverse neonatal outcome: analysis of 51,519 consecutive validated samples. BJOG 2012;119:824-31.
7. Low JA, Lindsay BG, Derrik EJ. Threshold of metabolic acidosis associated with newborn complications. Am J Obstet Gynecol 1997;177:1391-4.
8. Papile LA. The Apgar score in the 21st century. N Engl J Med. 2001;344:519–520.
9. Sehdev HM, Stamilio DM, Macones GA, Graham E, Morgan MA. Predictive factors for neonatal morbidity in neonates with an umbilical arterial cord pH less than 7.00. Am J Obstet Gynecol. 1997;177:1030– 1034.
10. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med. 2001;344:467–471
11. Winkler CL, Hauth JC, Tucker JM, Owen J, Brumfield CG. Neonatal complications at term as related to the degree of umbilical artery acidemia. Am J Obstet Gynecol. 1991;164:637– 641
12. Westgren M, Divon M, Horal M, et al. Routine measurements of umbilical artery lactate levels in the prediction of perinatal outcome. Am J Obstet Gynecol. 1995;173:1416–1422.
13. Watterberg KL, Aucott S, Benitz WE, Cummings JJ, Eichenwald EC, Goldsmith J et al. The Apgar score. Pediatrics. 2015 ;136(4):819-22. https://doi.org/10.1542/peds.2015-2651.
14. Ehrenstein V. Association of Apgar scores with death and neurologic disability. Clin Epidemiol. 2009;1:45–53 pmid:20865086.
15. Tataranno M, De Bernardo G, Trevisanuto D, Sordino D, Riccitelli M, Buonocore G, Perrone S. Differences between umbilical blood gas in term and preterm newborns. Electron Physician. 2019;11(2):7529–35. https://doi. org/10.19082/7529.
16. Pramod S, Gunchan P, Sandeep P. Interpretation of arterial blood gas. Indian J Crit Care Med. 2010;14(2):57–64. https://doi.org/10.4103/0972- 5229.68215.
17. Syed, F., Kini, S., Edward Lewis, L., Bhat Y, R., Purkaystha, J. Prediction of Respiratory Morbidities in Late Preterm Neonates Using Cord Blood Arterial Lactate and Base Excess. Iranian Journal of Neonatology IJN, 2019; 10(4): 71-75.
18. Patil SS, Rath S, George CE. Study on umbilical cord arterial blood gas analysis and cord blood lactate levels as predictors for adverse neonatal outcome: an observational study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018 Apr 1;7(4):1494-501.
19. Cnattingius S, Norman M, Granath F, Petersson G, Stephansson O, Frisell T. Apgar score components at 5 minutes: risks and prediction of neonatal mortality. Paediatr Perinat Epidemiol. 2017;31(4):328–37.
20. Yilmaz A, Kaya N, Ulkersoy I et al. The correlation of arterial cord blood gas values and apgar scores in term babies without fetal distress and their effects on NICU admissions.2021;(1):1-6.
21. Yilmaz A, Kaya N, Ulkersoy I et al. The correlation of arterial cord blood gas values and apgar scores in term babies without fetal distress and their effects on NICU admissions.2021;(1):1-6.
22. Sabol BA, Caughey AB. Acidemia in neonates with a 5-minute Apgar score of 7 or greater–What are the outcomes? American journal of obstetrics and gynecology. 2016 Oct 1;215(4):486-e1.
23. Fuyama Y, Shima Y, Shindo F, Nakajima M, Urashima M. Clinical significance of measuring lactate levels in cord blood to predict development of respiratory distress syndrome in neonates. Japan medical association journal. 2005;48(6):268.
24. Tuuli MG, Stout MJ, Shanks A, Odibo AO, Macones GA, Cahill AG. Umbilical cord arterial lactate compared with pH for predicting neonatal morbidity at term. Obstetrics and gynecology. 2014 Oct;124(4):756.
25. Perez Molina JJ, Romero DM, Ramirez Valdivia JM, Corona MQ. [Transient tachypnoea of the newborn, obstetric and neonatal risk factors]. Ginecol Obstet Mex. 2006;74(2):95-103. Victory R, Penava D, Da Silva O, Natale R, Richardson B. Umbilical cord pH and base excess values in relation to adverse outcome events for infants delivering at term. American journal of obstetrics and gynecology. 2004 Dec 1;191(6):2021-8.
26. Ekmen S, Doğan E. Prediction of the Course of Transient Tachypnoea of the Newborn by Blood Laboratory Parameters at the Time of Admission. Iran J Pediatr. 2021;31(3):e112224.

Most read articles by the same author(s)