Association Between Adverse Neonatal Outcome and Lactate Concentration in Amniotic Fluid

Obstet Gynecol. 2011 Jul;118(1):135-42. doi: 10.1097/AOG.0b013e318220c0d4.

Abstract

Objective: To estimate whether a high lactate concentration in amniotic fluid, together with cardiotocography, can be used as an indicator for an increased risk of adverse neonatal outcome at delivery.

Method: A prospective cohort study was performed at two tertiary center labor wards in Sweden. Healthy women with full-term, singleton pregnancies and cephalic presentation in spontaneous active labor were included in the study (N=825). Lactate concentration in samples of amniotic fluid collected in the course of vaginal examinations during labor were correlated with cardiotocography 30 minutes before delivery and a composite score for adverse neonatal outcome.

Results: High lactate concentration in amniotic fluid (greater than 10.1 mmol/L) was associated with an adverse neonatal outcome (odds ratio [OR] 4.4, 95% confidence interval [CI] 2.3-8.2). Fetal bradycardia within 30 minutes before delivery was also associated with an increased risk of adverse neonatal outcome (OR 7.4, 95% CI 3.04-18.11). If lactate in amniotic fluid was greater than 10.1 mmol/L and bradycardia was seen together, the risk of delivering a neonate with an adverse neonatal outcome was increased 11-fold (OR 10.7, 95% CI 3.7-31.7).

Conclusion: High lactate concentration in amniotic fluid and fetal bradycardia during the last 30 minutes before delivery indicate an increased risk of adverse neonatal outcome at delivery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amniotic Fluid / metabolism*
  • Apgar Score
  • Bradycardia / epidemiology
  • Cardiotocography
  • Female
  • Humans
  • Labor, Obstetric / metabolism
  • Labor, Obstetric / physiology*
  • Lactates / metabolism*
  • Logistic Models
  • Pregnancy
  • Pregnancy Outcome*
  • Young Adult

Substances

  • Lactates