103 - Utility and predictive value of cord blood lactate in perinatal asphyxia diagnosis and neonatal outcome in a low resource setting; lessons from a tertiary hospital in southern Nigeria.

Poster Number: 103
Publication Number: 103.336

chidiebere Kingsley. Ani, University of Benin Teaching Hospital, Benin-City, Edo, Nigeria; Ikechukwu R. Okonkwo, University of Benin Teaching Hospital, Benin City, Edo, Nigeria

Background: Perinatal asphyxia (PA) is a global health concern associated with long-term morbidity, and significant mortality. Limited healthcare resource and inadequate facilities which characterize low-and middle- income countries (LMICs), have made diagnosis of PA challenging. The identification of a cheap, specific and sensitive, biochemical parameter as an alternative to sophisticated blood gas analysis would improve the assessment of PA in low-resource settings. Umbilical cord arterial blood (UCAB) lactate has been projected to have such potentials.

Objective:

This study is designed to assess the utility of UCAB lactate in the diagnosis of PA and predicting neonatal outcome among term babies.

Design/Methods:

This is a case-control study carried out at the University of Benin Teaching Hospital, Benin City Nigeria over a seven-month period (December 2020 to July 2021). Samples were collected from the umbilical cord segments of 68 term newborns with PA and 68 apparently healthy controls, for pH and lactate analyses. Data obtained on the Thompson score, and outcome of enrolled neonates were appropriately analysed.

Results: The median (IQR) UCAB lactate of 7.23 (5.90 to 9.41) mmol/l in asphyxiated newborns was significantly higher than 2.97 (2.27 to 3.82) mmol/l the apparently healthy newborns of (U = 4175.50; P < 0.001). The optimal diagnostic cut-off value of UCAB lactate for PA was > 5.1 mmol/l, with a sensitivity of 89.4% and specificity of 90.9%. The optimal cut-off value of UCAB lactate in predicting short-term adverse neonatal outcome was > 8.3 mmol/l, with a sensitivity of 100% and specificity of 94.7%.

Conclusion(s):

This study shows an excellent performance of UCAB lactate in the diagnosis & short-term adverse outcome prediction of term neonates with PA. This findings of this study is useful and applicable in LRS with limited access to Arterial Blood gas measurement.