Clinical Significance of Measuring Lactate Levels in Cord Blood to Predict Development of Respiratory Distress Syndrome in Neonates

Background Reliable measurements of lactate levels as well as blood gas values have become available in the setting of neonatal care. We aimed to evaluate clinical significance of measuring lactate and/or blood gas levels in cord blood associating with perinatal factors and development of respiratory distress syndrome (RDS) that is one of major morbidities in neonates. Methods Serum lactate levels and blood gas in cord blood were prospectively measured at delivery in an urban maternity hospital. Results Forty-four cases of RDS were identified in the cohort of 4,881 consecutive neonates. Associations between lactate levels and the 29 clinical variables in the perinatal period were made using multiple linear regression analyses: positive associations with gestational age, abruptio placentae, abnormal presentation and position of the fetus during labor, variable deceleration, late deceleration, prolonged deceleration, early deceleration (P0.001); negative associations with number of previous deliveries birth weight, Apgar score at 1 and 5 minutes, non-emergent and emergent Cesarean section (P0.001) as perinatal variables. As a single parameter, lactate could predict occurrence of RDS more accurate than blood gas: pH, base excess, pCO2, HCO3. However, a model using 29 perinatal parameters was accurate enough to predict development of RDS even without adding data of lactate levels. Conclusions These results suggest that measuring levels of lactate in cord blood may have some clinical significance but no more than combination of classical perinatal parameters in predicting development of RDS.