OBJECTIVE: It is clinically insufficient to assess the severity and prognosis of neonatal asphyxia only according to Apgar score and blood gas measurement. In order to find more sensitive and specific indexes, the clinical significance of cord blood lactate in neonates with asphyxia was studied. METHODS: The lactate level and the pH value of cord arterial blood were determined in 31 term infants with perinatal asphyxia (further divided into the mild and the severe asphyxia groups) and 30 normal neonates (the control group). At the 14th day after birth, 20 item neonatal behavioral neurological assessment (NBNA) was taken for each subject. RESULTS: The levels of cord blood lactate in the mild and severe asphyxia groups [( 6.42 ± 0.14 ) and ( 10.77 ± 0.12 ) mmol/L] were significantly higher than that in the control group [( 4.20 ± 0.15 ) mmol/L](P< 0.01 ). The pH values in the mild and severe asphyxsia groups were markedly lower than that of the control group [( 7.16 ± 0.07 ) vs ( 7.18 ± 0.11 ); ( 7.04 ± 0.09 ) vs ( 7.18 ± 0.11 )](P< 0.01 ). There were significant differences in the lactate level and pH value between the mild and severe asphyxia groups (P< 0.01 ). The lactate level was negatively correlated with the pH value and the score of NBNA (r= -0.76 and -0.85 , respectively, both P< 0.01 ). CONCLUSIONS: Cord blood lactate may be a useful index in evaluating the severity and short term prognosis in neonates with perinatal asphyxia."/>
Clinical Significance of Cord Blood Lactate in Neonates with Asphyxia
Abstract OBJECTIVE: It is clinically insufficient to assess the severity and prognosis of neonatal asphyxia only according to Apgar score and blood gas measurement. In order to find more sensitive and specific indexes, the clinical significance of cord blood lactate in neonates with asphyxia was studied. METHODS: The lactate level and the pH value of cord arterial blood were determined in 31 term infants with perinatal asphyxia (further divided into the mild and the severe asphyxia groups) and 30 normal neonates (the control group). At the 14th day after birth, 20 item neonatal behavioral neurological assessment (NBNA) was taken for each subject. RESULTS: The levels of cord blood lactate in the mild and severe asphyxia groups [( 6.42 ± 0.14 ) and ( 10.77 ± 0.12 ) mmol/L] were significantly higher than that in the control group [( 4.20 ± 0.15 ) mmol/L](P< 0.01 ). The pH values in the mild and severe asphyxsia groups were markedly lower than that of the control group [( 7.16 ± 0.07 ) vs ( 7.18 ± 0.11 ); ( 7.04 ± 0.09 ) vs ( 7.18 ± 0.11 )](P< 0.01 ). There were significant differences in the lactate level and pH value between the mild and severe asphyxia groups (P< 0.01 ). The lactate level was negatively correlated with the pH value and the score of NBNA (r= -0.76 and -0.85 , respectively, both P< 0.01 ). CONCLUSIONS: Cord blood lactate may be a useful index in evaluating the severity and short term prognosis in neonates with perinatal asphyxia.
