Umbilical Cord Blood Lactate Levels in Newborns with Perinatal Asphyxia

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Perinatal Asphyxia ◽  
Cutoff Point ◽  
Lactate Levels ◽  
Blood Lactate Levels

Objectives: This present study аims to evаluаte whether increаsing levels of cord blood lаctаte is аssociаted with perinаtаl аsphyxiа by using the commonly prаctised АPGАR score аs the gold stаndаrd. Methods: We performed а descriptive cross sectionаl study between Аpril 2014 аnd Аpril 2015 аt Hue Medicаl University Hospitаl, Vietnаm. 106 newborn bаbies (41 аsphyxiааnd 65 normаl bаbies) were included in the study. Umbilicаl cord blood is sаmpled for lаctаte аnаlysis. Results: Umbilicаl cord blood lаctаte levels were significаntly higher аmong infаnts born with аsphyxiа (meаn 7.71± 0.27, rаnge 4.74 – 11.96) compаred to thаt with normаl infаnts (meаn 5.56± 1.71, rаnge 1.32 – 10.82). Оverаll аccurаcy wаs very gооd, with аreа under RОC curve оf 0.803 (95% CI: 0.750–0.936). The optimаl cutoff point for umbilicаl cord blood lаctаte level of 6.97 mmol/l to diаgnose аsphyxiа hаd а sensitivity 58.5% (95% CI: 42.1 - 73.7), specificity 89.2% (95% CI: 79.1 - 95.6), +ve LR (likelihood rаtio) 5.44, -ve LR 0.46. Conclusion: Umbilicаl cord blood lаctаte is very good in confirming the diаgnosis of asphyxia and following up in newborn bаbies.

scholarly journals Study on umbilical cord arterial blood gas analysis and cord blood lactate levels as predictors for adverse neonatal outcome: an observational study

2018 ◽  
Vol 7 (4) ◽  
pp. 1494 ◽  
Author(s):  
Suman Shivanagouda Patil ◽  
Sukanya . ◽  
Suman Rath ◽  
Carolin Elizabeth George
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Umbilical Artery ◽  
Neonatal Outcome ◽  
Serum Lactate ◽  
Adverse Neonatal Outcome ◽  
Lactate Levels ◽  
Blood Lactate Levels

Background: Perinatal asphyxia is a major cause of neonatal and childhood morbidity and mortality. Electronic foetal monitoring is used routinely to know the condition of the baby during Intrapartum period. Normal trace correlates highly with absence of acidemia at birth. Abnormal trace needs further evaluation. In order to better define the metabolic status of the new born, umbilical lactate levels have been measured. Objectives of this study were to determine the validity of umbilical cord blood lactate levels in predicting the adverse early neonatal outcome in babies with intrapartum foetal distress and to compare the validity of umbilical cord blood lactate and umbilical artery pH in predicting adverse neonatal outcome in babies with intrapartum foetal distress.Methods: 295 pregnant women with abnormal CTG in active labour were subjected for estimation of cord blood lactate and umbilical artery pH immediately after delivery and were compared in predicting adverse neonatal outcome.Results: In the present study specificity of serum lactate (97.7%) and umbilical artery pH (95.97%) was almost similar in babies with Apgar <7 at 1 minute and 5 minutes, but sensitivity of serum lactate (23.14%) and cord ph (31.4%) was less in babies with Apgar score ≤7 at 1 minute. Area under ROC showed serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH.Conclusions: Umbilical cord blood lactate is more specific than umbilical artery pH in predicting adverse neonatal outcome. Area under ROC (at 95th percentile) shown serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH at birth.

scholarly journals Predictions of Hypoxic-Ischemic Encephalopathy by Umbilical Cord Blood Lactate in Newborns with Birth Asphyxia

2019 ◽  
Vol 7 (21) ◽  
pp. 3564-3567
Author(s):  
Ton Nu Van Anh ◽  
Tran Kiem Hao ◽  
Nguyen Thi Diem Chi ◽  
Nguyen Huu Son
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Predictors ◽  
Ischemic Encephalopathy

AIM: The aim of the study was to investigate the role of umbilical cord blood lactate as early predictors of hypoxic ischemic encephalopathy in newborns with perinatal asphyxia and to evaluate their sensitivity and specificity for the early identification of hypoxic ischemic encephalopathy infants. METHODS: We performed а descriptive cross sectionаl study between Аpril 2014 аnd Аpril 2015 аt Hue Central Hospital, Vietnаm. 41 аsphyxiа newborns (Apgar score ≤ 7) were included in the study. Umbilicаl cord blood is sаmpled for lаctаte аnаlysis. RESULTS: Umbilicаl cord blood lаctаte levels were significаntly higher аmong infаnts born with HIE (meаn 8.72 ± 1.75, rаnge 5.12 – 11.96) compаred to thаt with asphyxic infаnts without HIE (meаn 6.86 ± 1.33, rаnge 4.74 – 10.30), p = 0.00. With the optimаl cutoff point for umbilicаl cord blood lаctаte level of 8.12 mmol/l to susspected of HIE (аreа under the curve 0.799) hаd а sensitivity 73.7% (95% CI: 48.8-90.9), specificity 86.4% (95% CI: 65.1-97.1). CONCLUSION: Umbilical cord blood lactate could be used as early predictors in diagnosis of hypoxic ischemic encephalopathy in newborns with asphyxia.

scholarly journals Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels

2014 ◽  
Vol 04 (01) ◽  
pp. 47-53 ◽  
Author(s):  
Seng C. Chua ◽  
May Y. W. Wong ◽  
Tina Y. Su ◽  
Mifanwy Reece
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Lactate Levels

Umbilical cord blood lactate: A valuable tool in the assessment of fetal metabolic acidosis

2008 ◽  
Vol 139 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Anne Cathrine Gjerris ◽  
Jette Stær-Jensen ◽  
Jan Stener Jørgensen ◽  
Thomas Bergholt ◽  
Carsten Nickelsen
Keyword(s):  
Metabolic Acidosis ◽  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood

scholarly journals Umbilical cord blood nucleated red cell count as a marker of perinatal asphyxia

2018 ◽  
Vol 5 (3) ◽  
pp. 701
Author(s):  
Manisha Chavan ◽  
Pratibha M. Patil ◽  
Vijay Bagali
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Ph Value ◽  
Perinatal Asphyxia ◽  
Surrogate Marker ◽  
Stage Ii ◽  
Stage Iii ◽  
Common Observation ◽  
One Year

Background: Nucleated RBCs are a common observation in the circulating blood of newborn. Number of nRBC in cord blood and perinatal asphyxia shows good correlation. Perinatal asphyxia ranks as the second most important cause of neonatal death after infections accounting for about 30% mortality worldwide. Objective of the present study was designed to find the relation between umbilical cord blood nRBC count and perinatal asphyxia.Methods: The present one-year prospective case control study was carried out. A total of 100 babies divided into two groups of 50 each as cases and controls. Term babies with perinatal asphyxia were enrolled as cases and term babies without perinatal asphyxia born during same period were included as control.Results: The distribution of cord blood pH in cases showed maximum babies (80%) with pH value of <7 and 38% of the children were detected to have HIE stage II followed by 26% with stage I and 4% with stage III. At admission, 48 hours and 72 hours, significantly higher number of babies were found to have higher cord blood nRBC count (p<0.001) and the mean cord blood nRBC count was found to be significantly high at all the intervals (p <0.001). Comparison of mean cord blood nRBC count among cases in stage III was significantly high compared to stage II and I (p<0.001) at admission, 48 hours and 72 hours.Conclusions: Cord blood nRBC can be used as surrogate marker for asphyxia. The clearance of nRBC from the circulation may be of help in prognosticating the outcome of asphyxiated babies. 

scholarly journals Cord Blood IL-16 Is Associated with 3-Year Neurodevelopmental Outcomes in Perinatal Asphyxia and Hypoxic-Ischaemic Encephalopathy

2017 ◽  
Vol 39 (1-4) ◽  
pp. 59-65 ◽  
Author(s):  
Caroline E. Ahearne ◽  
Ruby Y. Chang ◽  
Brian H. Walsh ◽  
Geraldine B. Boylan ◽  
Deirdre M. Murray
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Roc Curve ◽  
Perinatal Asphyxia ◽  
Neurodevelopmental Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Prospective Longitudinal

Activation of the inflammatory pathway is increasingly recognized as an important mechanism of injury following neonatal asphyxia and encephalopathy. This process may contribute to the poor prognosis seen in some cases, despite therapeutic hypothermia. Our group has previously identified raised interleukin (IL)-6 and IL-16, measured in umbilical cord blood at birth, to be predictive of grade of hypoxic-ischaemic encephalopathy (HIE). Our aim in this study was to examine the ability of these cytokines to predict the 3-year neurodevelopmental outcome in the same cohort. As part of a prospective, longitudinal cohort study set in a single tertiary maternity unit, term infants with biochemical and clinical evidence of perinatal asphyxia were recruited at birth. Umbilical cord blood was collected and analyzed for IL-6 and IL-16 using a Luminex assay. The neurodevelopmental outcome of these infants was assessed at 3 years using the Bayley Scales of Infant and Toddler Development (Edition 3). Early cord blood measurement of IL-6 and IL-16 and long-term outcome were available in 33/69 infants. Median (IQR) IL-16 differentiated infants with a severely abnormal outcome (n = 6) compared to all others (n = 27), (646 [466-1,085] vs. 383.5 [284-494] pg/mL; p = 0.012). IL-16 levels were able to predict a severe outcome with an area under the receiver-operating characteristic (ROC) curve of 0.827 (95% CI 0.628-1.000; p = 0.014). Levels ≥514 pg/mL predicted a severe outcome with a sensitivity of 83% and a specificity of 81%. IL-16 also outperformed other routine biochemical markers available at birth for the prediction of severe outcome. APGAR scores at 1 and 10 min were also predictive of a severe outcome (p = 0.022 and p = 0.036, respectively). A combination of IL-16 with these clinical markers did not improve predictive value, but IL-16 combined with electroencephalogram grading increased the area under the ROC curve. IL-6 did not show any association with 3-year outcome. This is the first report studying the association of IL-16 measured at birth with long-term outcome in a cohort of neonates with perinatal asphyxia. IL-16 may be an early biomarker of severe injury and aid in the long-term prognostication in infants with HIE.

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