The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2017
The small-for-gestational-age fetus has an intact ability to develop lacticemia when exposed to hypoxia: a retrospective comparative register study.
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Åkerman Fernanda, Mokarami Parisa, Källén Karin, Olofsson Per
Аннотация
OBJECTIVE: To investigate the ability of small-for-gestational-age (SGA) fetuses to develop lacticemia during hypoxia.
METHODS: Umbilical cord arterial and venous pH, lactate and glucose concentrations were determined in 1777 SGA (<10th percentile) and 14,569 AGA newborns and related to acidemia (pH < mean -2SD). Non-parametric statistics with two-sided p < .05 were considered significant.
RESULTS: Glucose and lactate were linearly related and both variables correlated negatively with pH. Glucose was equal in SGA and AGA at a normal pH, but at severe acidemia it was lower in SGA. Glucose was higher in both groups during acidemia. Lactate was higher in SGA at both a normal and a low pH, and in both groups lactate increased progressively with the severity of acidemia.
CONCLUSIONS: In both SGA and AGA fetuses, glucose was mobilized during acidemia; lactate was higher in SGA at both a normal and low pH. Considering SGA being a proxy for fetal growth restriction, and acidemia a proxy for hypoxia, it is concluded that growth-restricted fetuses have an intact ability to develop lacticemia during hypoxia.
METHODS: Umbilical cord arterial and venous pH, lactate and glucose concentrations were determined in 1777 SGA (<10th percentile) and 14,569 AGA newborns and related to acidemia (pH < mean -2SD). Non-parametric statistics with two-sided p < .05 were considered significant.
RESULTS: Glucose and lactate were linearly related and both variables correlated negatively with pH. Glucose was equal in SGA and AGA at a normal pH, but at severe acidemia it was lower in SGA. Glucose was higher in both groups during acidemia. Lactate was higher in SGA at both a normal and a low pH, and in both groups lactate increased progressively with the severity of acidemia.
CONCLUSIONS: In both SGA and AGA fetuses, glucose was mobilized during acidemia; lactate was higher in SGA at both a normal and low pH. Considering SGA being a proxy for fetal growth restriction, and acidemia a proxy for hypoxia, it is concluded that growth-restricted fetuses have an intact ability to develop lacticemia during hypoxia.