摘要
Objective:To determine the association of the three umbilical cord blood parameters:umbilical cord pH,base deficit,and lactate levels,with neonatal outcomes.Methods:This prospective observational study was conducted from April 2021 to September 2022 with 100 term and late preterm(>35 weeks)neonates whose umbilical cord blood pH was<7.10,Apgar score was<7 at 1 min,and required positive pressure ventilation.Umbilical cord blood was assessed for pH,base deficit,and blood lactate levels.The neonatal outcomes of neonatal intensive care unit admission,Apgar score at 1 min,and Apgar score at 5 min were assessed.Results:The mean of umbilical cord blood pH was 7.04±0.07,mean base deficit was(−9.3±3.9)mmol/L,and mean lactate levels were(6.51±2.29)mmol/L.Neonatal intensive care unit(NICU)admission was needed in 78(78%)neonates.The mean NICU stay length was(2.4±2.2)days ranging from 0 to 12 days with a median of 2 days.Univariate analysis showed no significant difference in cord blood pH(P=0.736)and base deficit(P=0.393)between neonates without NICU admission and neonates who required NICU admission,but lactate level was significantly higher in neonates who required NICU admission(P<0.001).There was no significant difference in cord blood pH(P=0.400)and base deficit(P>0.999)between neonates with Apgar scores 4-7 at 1 min and neonates with Apgar scores<4,but lactate level was significantly higher in neonates with Apgar scores<4 at 1 min(P<0.001).Conclusions:Umbilical cord blood pH,base deficit,and lactate levels are useful novel markers showing a significant correlation with neonatal intensive care unit admission and adverse neonatal morbidities among hypoxic newborns.Overall,lactate was a better predictor of adverse neonatal outcomes as compared to umbilical cord blood pH and base deficit.
