Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

The prognostic value of the level of lactate in umbilical cord blood in predicting complications of neonates with meconium aspiration syndrome

Thu May 23 03:21:13 2024

(2021) The prognostic value of the level of lactate in umbilical cord blood in predicting complications of neonates with meconium aspiration syndrome. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. pp. 1013-1019. ISSN 1476-4954 (Electronic) 1476-4954 (Linking)

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Official URL: https://www.ncbi.nlm.nih.gov/pubmed/31340690

Abstract

BACKGROUND: In spite of significant advances in therapeutic, diagnostic and even medical modalities, meconium management continues to be a concern for management. It has been recently assumed that trace of lactate in both serum and urine can be a sign of the asphyxia in neonates. However, no study has been done on the prognostic value of increasing lactate concentration in umbilical cord blood for predicting the outcomes of meconium aspiration syndrome (MAS), which was our aim in this study. METHODS: Thin cross-sectional study was performed on 150 neonates suffering meconium aspiration syndrome who were admitted to Akbar Abadi hospital in Tehran between 2016 and 2018. Samples of umbilical cord blood were extracted from neonates and sent to the reference laboratory to measure lactate level as well as arterial blood gas analysis. The neonatal characteristics as well as postdelivery complications were also collected by reviewing the hospital recorded files. RESULTS: Thick meconium stained amniotic fluid (TKMSF) was found in 40.0 and thin meconium stained amniotic fluid (TNMSF) in 60.0. The mean level of lactate was significantly higher in those neonates with morbidities including pulmonary hemorrhage, persistent pulmonary hypertension of the neonate (PPHN), intraventricular hemorrhage (IVH), and respiratory failure requiring ventilation support. According to the ROC curve analysis, increasing lactate in umbilical cord blood could predict occurrence of pulmonary hemorrhage (AUC = 0.885), PPHN (AUC = 0.832), IVH (AUC = 0.898), and requiring ventilation (AUC = 0.833). Comparing the two groups with TKMSF and TNMSF showed higher gestational age, lower Apgar score, lower BE, higher PCO(2), lower PO(2), lower PH as well as higher serum lactate. In this regard and using the ROC curve analysis (Table 4), increased lactate could effectively discriminate TKMSF from TNMSF (AUC = 0.998) with the best cut-off value of 4.10. CONCLUSION: The increase in lactate in the umbilical cord blood (>4.1 mmol/L with high sensitivity and specificity) can distinguish between thick meconium and thin meconium forms in amniotic acid and thus can determine the severity of MAS. Also, increasing serum lactate levels is an accurate indicator for predicting complications such as pulmonary hemorrhage, PPHN, IVH, and need for ventilation in newborns with this syndrome. This diagnostic accuracy is even beyond the usual markers for arterial gas analysis, such as PH, PCO(2), PO(2) and BE.

Item Type: Article
Creators:
CreatorsEmail
Mazouri, A.UNSPECIFIED
Fallah, R.UNSPECIFIED
Saboute, M.UNSPECIFIED
Taherifard, P.UNSPECIFIED
Dehghan, M.UNSPECIFIED
Keywords: Amniotic Fluid Cross-Sectional Studies Female Fetal Blood Humans Infant, Newborn Iran Lactic Acid Meconium *Meconium Aspiration Syndrome/diagnosis Prognosis Lactate neonates umbilical cord
Divisions:
Page Range: pp. 1013-1019
Journal or Publication Title: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Journal Index: Pubmed
Volume: 34
Number: 7
Identification Number: https://doi.org/10.1080/14767058.2019.1623195
ISSN: 1476-4954 (Electronic) 1476-4954 (Linking)
Depositing User: مهندس مهدی شریفی
URI: http://eprints.medilam.ac.ir/id/eprint/4489

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