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

Vincenzo Zanardo, Giancarlo Mari, Federico de Luca, Giovanni Scambia, Pietro Guerrini, Gianluca Straface

Research output: Contribution to journalArticle

2 Citations (Scopus)

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±1.96mmol/L, p=0.050 and 103.6±30.5mg/dL, p<0.001, respectively) and significantly lower in elective CD group (1.77±0.99mmol/L, p<0.001 and 69.8±13.0mg/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.

Original languageEnglish (US)
Pages (from-to)165-168
Number of pages4
JournalEarly Human Development
Volume91
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Gluconeogenesis
Fetal Blood
Lactic Acid
Glucose
Vacuum
Arteries
Parturition
Anaerobiosis
Glycogenolysis
Umbilical Arteries
Glycolysis
Denmark
Italy
Catecholamines
Blood Glucose
Linear Models
Fetus
Emergencies
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries. / Zanardo, Vincenzo; Mari, Giancarlo; de Luca, Federico; Scambia, Giovanni; Guerrini, Pietro; Straface, Gianluca.

In: Early Human Development, Vol. 91, No. 3, 01.03.2015, p. 165-168.

Research output: Contribution to journalArticle

Zanardo, Vincenzo ; Mari, Giancarlo ; de Luca, Federico ; Scambia, Giovanni ; Guerrini, Pietro ; Straface, Gianluca. / Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries. In: Early Human Development. 2015 ; Vol. 91, No. 3. pp. 165-168.
@article{69a8f55a18e843fbbd9b66dd4c427751,
title = "Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries",
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{\circledR}, 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±1.96mmol/L, p=0.050 and 103.6±30.5mg/dL, p<0.001, respectively) and significantly lower in elective CD group (1.77±0.99mmol/L, p<0.001 and 69.8±13.0mg/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.",
author = "Vincenzo Zanardo and Giancarlo Mari and {de Luca}, Federico and Giovanni Scambia and Pietro Guerrini and Gianluca Straface",
year = "2015",
month = "3",
day = "1",
doi = "10.1016/j.earlhumdev.2015.01.003",
language = "English (US)",
volume = "91",
pages = "165--168",
journal = "Early Human Development",
issn = "0378-3782",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

TY - JOUR

T1 - Lactate in cord blood and its relation to fetal gluconeogenesis in at term deliveries

AU - Zanardo, Vincenzo

AU - Mari, Giancarlo

AU - de Luca, Federico

AU - Scambia, Giovanni

AU - Guerrini, Pietro

AU - Straface, Gianluca

PY - 2015/3/1

Y1 - 2015/3/1

N2 - 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±1.96mmol/L, p=0.050 and 103.6±30.5mg/dL, p<0.001, respectively) and significantly lower in elective CD group (1.77±0.99mmol/L, p<0.001 and 69.8±13.0mg/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.

AB - 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±1.96mmol/L, p=0.050 and 103.6±30.5mg/dL, p<0.001, respectively) and significantly lower in elective CD group (1.77±0.99mmol/L, p<0.001 and 69.8±13.0mg/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.

UR - http://www.scopus.com/inward/record.url?scp=84923367691&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923367691&partnerID=8YFLogxK

U2 - 10.1016/j.earlhumdev.2015.01.003

DO - 10.1016/j.earlhumdev.2015.01.003

M3 - Article

C2 - 25656301

AN - SCOPUS:84923367691

VL - 91

SP - 165

EP - 168

JO - Early Human Development

JF - Early Human Development

SN - 0378-3782

IS - 3

ER -