Lactate concentration in umbilical cord blood is gestational age-dependent: a population-based study of 17 867 newborns
Abstract
OBJECTIVE: To study the influence of gestational age on lactate concentration in arterial and venous umbilical cord blood at birth and to define gestational age-specific reference values for lactate in vigorous newborns. DESIGN: Population-based comparative. SETTING: University hospitals. SAMPLE: Vigorous newborns with validated umbilical cord blood samples. MATERIAL AND METHODS: From 2000 to 2004, routine cord blood gases, lactate and obstetric data from two university hospitals were available for 17 867 newborns from gestational week 24 to 43. After validation of blood samples and inclusion only of singleton pregnancies aimed for vaginal delivery, 10 700 women remained. Among those, reference values were defined in 10 169 vigorous newborns, that is in newborns with a 5-minute Apgar score corresponding to the gestational age-specific median value minus 1 point score, or better. MAIN OUTCOME MEASURES: Cord lactate concentration relative to gestational age. RESULTS: The arterial and venous lactate concentrations increased monotonously with gestational age from 34 weeks. Considerable differences were found between mean and median values, but after logarithmic transformation the log-lactate values were normally distributed. Simple linear regression analysis showed a significant association between the log-lactate values and gestational age (P < 10(-6), R(2)= 0.024). Reference curves were constructed after anti-logarithmic transformation. Both the gestational age and the time of the second stage of labour influenced, independently of each other, the lactate concentrations. CONCLUSIONS: Lactate concentrations in arterial and venous umbilical cord blood are increasing significantly with advancing gestational age.
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On the basis of good-quality data, it is reasonable to set a cord artery lactate cutoff (mean +2 standard deviations) at 10 mmol/L at 39 to 40 weeks' gestation.
“On the basis of good-quality data, it is reasonable to set a cord artery lactate cutoff (mean þ2 standard deviations) at 10 mmol/L at 39 to 40 weeks' gestation.”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [57]
Lactate increases linearly with advancing gestational age from 34 to 35 weeks' gestation onward in both the cord artery and vein (N=10,169).
“Lactate increases linearly with advancing gestational age from 34 to 35 weeks' gestation onward in both the cord artery and vein (N¼10,169).57”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [57]
At 39+3 weeks, the mean +2 SD cord lactate value was 9.8 mmol/L, and at 40+3 weeks it was 10.2 mmol/L.
“At 39þ3 weeks, the mean þ2 SD value was 9.8 mmol/L, and at 40þ3 weeks it was 10.2 mmol/L.57”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [57]
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Self-citation
- Authors
- Wiberg, N., Källén, K., Herbst, A., Åberg, A., & Olofsson, P.
- Affiliations
- Lund University (SE)
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2008-04-09
- Volume
- 115
- Issue
- 6
- Pages
- 704-709
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2034173268
- Cited by
- 57
- References
- 25
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 4
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Lunds Universitet
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal Health and Biochemistry
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- gestational age, reference values, second stage of labor, neonatal acid-base status
- MeSH terms
- Bicarbonates, Blood Gas Analysis, Carbon Dioxide, Fetal Blood, Gestational Age, Humans, Infant, Newborn, Lactates, Reference Values, Umbilical Arteries, Umbilical Veins
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