Long-term neurodevelopmental effects of exclusively high cord lactate levels in term newborn.

Introduction: Cord arterial blood gas analysis (ABGA) results are used as diagnostic criteria for hypoxic-ischemic encephalopathy in newborns with suspected perinatal asphyxia. This study evaluated the effect of cord ABGA lactate level on the long-term neurodevelopment of newborns without any clinical signs of perinatal asphyxia.

Methods: This clinical observation study was designed among term babies born between 2018 and 2019 in our unit. Cases with a 5-min Apgar score <7 and signs of fetal distress in their antenatal follow-up were excluded. The cases ( = 1438) were divided into two groups those with high cord lactate levels (above 5 mmol/L,  = 92) and those with low lactate levels (below 2 mmol/L,  = 255). An Ages and Stages Questionnaire, Third Edition (ASQ-3) developmental screening questionnaire was sent to all parents. Patients with a chronological age between 24 and 42 months and for whom the parents fulfilled the questionnaire (low lactate group,  = 29, and high lactate group,  = 45) were evaluated.

Results: No difference was observed between the two groups in terms of demographic characteristics such as age ( = .1669), male gender ( = .906), mother's working situation ( = .948), mother's education level ( = .828), father's education level ( = .507), and family's total income ( = .642). Mean ACQ-3 developmental screening test scores were significantly lower in the high lactate group compared to the low lactate group concerning; fine motor (40 vs. 60,  = .001), problem-solving (50 vs. 60,  = .002), and personal social development (45 vs. 60,  = .003). No difference was observed in terms of communication and gross motor total scores.

Discussion: In general practice, routine cord ABGA is not generally recommended for patients with normal Apgar scores and no suspected hypoxia. However, in this study, we observed that cases with a normal 5-min Apgar score, no suspected perinatal asphyxia, and a cord lactate value of ≥5 fell behind their peers when evaluated with the ACQ-3 developmental screening questionnaire.