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Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries

Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries
Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries
Background In the human fetus, an increased lactate and glucose level can be anticipated when hypoxia and stress are present and is likely to be a function of both anaerobic metabolism and catecholamine-mediated glycogenolysis/glycolysis. Aim We assessed if measurement of lactate in cord artery blood after vaginal and cesarean delivery may predict glucose concentration. Study design Umbilical artery cord blood lactacidemia, acidemia, and glucose concentration was tested by ‘mini-lab’ Radiometer ABL90 FLEX analyzers (Radiometer®, Copenhagen, Denmark) after vaginal delivery (VD), spontaneous (n = 493) and by vacuum extractor (n = 41) or by cesarean delivery (CD), elective (n = 120) and emergency (n = 68) in at term, vigorous neonates delivered from March to December 2012 at the 2nd level maternity ward of Policlinico Abano Terme, Abano Terme (Italy). Results Cord blood lactacidemia and glucose levels were significantly higher in VD by vacuum extractor than in all other groups (5.32 ± 1.96 mmol/L, p = 0.050 and 103.6 ± 30.5 mg/dL, p < 0.001, respectively) and significantly lower in elective CD group (1.77 ± 0.99 mmol/L, p < 0.001 and 69.8 ± 13.0 mg/dL, p < 0.001). The cord blood lactate concentration was significantly and positively correlated with glucose levels (r = 0.434, p < 0.001), but significantly and negatively correlated with pH (r = − 0,662, p < 0.001), NaHCO3− (r = − 0,802, p < 0.001), and base excess (BE) (r = − 0,698, p < 0.001). However, in multivariate linear regression analysis, only BE, PaCO2 and cord blood lactate were significant predictive variables (R2 = 0.410; p < 0.001) of glucose levels at birth. Conclusion Cord blood artery lactate and glucose concentration are significantly and positively correlated at birth in healthy, at term vaginally and cesarean delivered neonates, but BE is the best indicator of activated fetal gluconeogenesis.
0378-3782
165-168
Zanardo, Vincenzo
1ae8822c-b412-4958-84cb-0cc3d7a11ae8
Mari, Giancarlo
6aa5ae0c-30dd-47d0-a7c4-24712166e302
De Luca, Federico
079a076c-20af-4c1e-aa6f-cb82c7e126e6
Scambia, Giovanni
0b33e85c-92ca-4c59-886b-4311c859e62d
Guerrini, Pietro
cf4b5834-0a68-48e9-8bbb-c3e56735a169
Straface, Gianluca
1dd08496-aa55-4b12-93b6-0c160484b946
Zanardo, Vincenzo
1ae8822c-b412-4958-84cb-0cc3d7a11ae8
Mari, Giancarlo
6aa5ae0c-30dd-47d0-a7c4-24712166e302
De Luca, Federico
079a076c-20af-4c1e-aa6f-cb82c7e126e6
Scambia, Giovanni
0b33e85c-92ca-4c59-886b-4311c859e62d
Guerrini, Pietro
cf4b5834-0a68-48e9-8bbb-c3e56735a169
Straface, Gianluca
1dd08496-aa55-4b12-93b6-0c160484b946

Zanardo, Vincenzo, Mari, Giancarlo, De Luca, Federico, Scambia, Giovanni, Guerrini, Pietro and Straface, Gianluca (2015) Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries. Early Human Development, 91 (3), 165-168. (doi:10.1016/j.earlhumdev.2015.01.003).

Record type: Article

Abstract

Background In the human fetus, an increased lactate and glucose level can be anticipated when hypoxia and stress are present and is likely to be a function of both anaerobic metabolism and catecholamine-mediated glycogenolysis/glycolysis. Aim We assessed if measurement of lactate in cord artery blood after vaginal and cesarean delivery may predict glucose concentration. Study design Umbilical artery cord blood lactacidemia, acidemia, and glucose concentration was tested by ‘mini-lab’ Radiometer ABL90 FLEX analyzers (Radiometer®, Copenhagen, Denmark) after vaginal delivery (VD), spontaneous (n = 493) and by vacuum extractor (n = 41) or by cesarean delivery (CD), elective (n = 120) and emergency (n = 68) in at term, vigorous neonates delivered from March to December 2012 at the 2nd level maternity ward of Policlinico Abano Terme, Abano Terme (Italy). Results Cord blood lactacidemia and glucose levels were significantly higher in VD by vacuum extractor than in all other groups (5.32 ± 1.96 mmol/L, p = 0.050 and 103.6 ± 30.5 mg/dL, p < 0.001, respectively) and significantly lower in elective CD group (1.77 ± 0.99 mmol/L, p < 0.001 and 69.8 ± 13.0 mg/dL, p < 0.001). The cord blood lactate concentration was significantly and positively correlated with glucose levels (r = 0.434, p < 0.001), but significantly and negatively correlated with pH (r = − 0,662, p < 0.001), NaHCO3− (r = − 0,802, p < 0.001), and base excess (BE) (r = − 0,698, p < 0.001). However, in multivariate linear regression analysis, only BE, PaCO2 and cord blood lactate were significant predictive variables (R2 = 0.410; p < 0.001) of glucose levels at birth. Conclusion Cord blood artery lactate and glucose concentration are significantly and positively correlated at birth in healthy, at term vaginally and cesarean delivered neonates, but BE is the best indicator of activated fetal gluconeogenesis.

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e-pub ahead of print date: 3 February 2015
Published date: 1 March 2015

Identifiers

Local EPrints ID: 433375
URI: http://eprints.soton.ac.uk/id/eprint/433375
ISSN: 0378-3782
PURE UUID: 33708e68-a2aa-4c26-bcd1-d875e5c98cbc

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Date deposited: 15 Aug 2019 16:30
Last modified: 09 Nov 2021 15:58

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Contributors

Author: Vincenzo Zanardo
Author: Giancarlo Mari
Author: Federico De Luca
Author: Giovanni Scambia
Author: Pietro Guerrini
Author: Gianluca Straface

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