Lactic Acid On The Clinical Significance Of Neonatal Asphyxia Diagnosis And Prognosis

Objectives: To study the diagnostic and predictive value of the cord blood lactate in neonates with perinatal asphyxia, so as to assess the clinical value of the urinary lactatercreatinine ratio. Methods: Lactate and blood gas of cord arterial blood was measured in 26 term infants with perinatal asphyxia (asphyxia group) and 30 normal infants (control group). Lactatercreatinine ratio of urine was measured at six hours after birth. Each baby was examined with 20-item NBNA (Neonatal Behavioral Neuroligical Scale) at 3, 7, 14 days after the birth. Results: (1) Lactate level of cord blood in asphyxia group (6.60 ?2.28) was significantly higher than that in control group (4.08 ?.15) . (2) Lactate level of cord blood of infants with hypoxic-ischemic encephalopathy( 9.24 ?1.63) was significantly higher than those without (5.43 ?1.35) . (3) The level of lactate and pH were both correlated negatively with NBNA. Lactate contributed more to NBNA than pH did. (4)There were no significant difference in cord blood level of lactate and pH between infants with fetal distress and those with neonatal asphyxia. Conclusions: (1) Measurement of the cord blood lactate may help to diagnose perinatal asphyxia and to identify adverse outcome of central nervous system. The clinical value of lactate is better than that of pH. (2) There are similar negative impacts on infants between those with fatal distress and neonatal asphyxia. Both kinds of neonates should be treated similarly to prevent adverse outcomes.