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. 2018 Mar 23;13(3):e0193887.
doi: 10.1371/journal.pone.0193887. eCollection 2018.

Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study

Nana Wiberg  1   2 , Tobias Wirenfeldt Klausen  3 , Tobias Tyrberg  4 , Lennart Nordström  5   6 , Eva Wiberg-Itzel  7
Affiliations

Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study

Nana Wiberg et al. PLoS One. .

Abstract

Objective: To correlate the value of lactate in fetal scalp blood at delivery and the outcomes of the offspring at four years of age.

Methods: Cases where scalp blood lactate was taken within sixty minutes before delivery were identified from the randomized trial "Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress". Data were grouped according to the generally accepted cutoffs for normality, pre-acidemia, acidemia and concentrations above mean +2 SD during the second stage. The outcome measures included gross-/fine motor function, vision, hearing, speaking and cognitive disorders, signs of central motor damage and referral to specialized pediatric services.

Results: 307 cases were available for final analyse. With normal scalp lactate concentration, the number of children with a diagnosed disorder was lower compared to the pre-acidemic/acidemic groups, although the findings were only significant for fine motor dysfunction (p = 0.036). Elevated lactate values were significantly associated with increased risk for a poorer capacity of attention and understanding of instructions (OR 1.37, 95% CI 1.07-1.74), and for fine motor dysfunction (OR 1.22, 95% CI 1.00-1.49) at the age of four.

Conclusion: Higher levels of lactate in fetal scalp blood seems to be associated with increased risk of an aberrant developmental outcome at four years of age in some areas.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart demonstrating exclusions and group division based on the levels of scalp blood lactate.
See this image and copyright information in PMC

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