The correlation between plasma lactate concentrations and early neonatal mortality.

Area of Science:

• Neonatal Medicine
• Biochemistry
• Perinatal Research

Background:

• Early neonatal mortality remains a significant concern in perinatal care.
• Identifying reliable biomarkers for predicting neonatal outcomes is crucial.
• Plasma lactate levels are indicative of metabolic status and oxygenation.

Purpose of the Study:

• To determine the correlation between early neonatal plasma lactate concentrations and mortality.
• To establish a predictive threshold for neonatal mortality based on lactate levels.

Main Methods:

• Plasma lactate concentrations were measured within the first 6 hours of life.
• Receiver operating characteristic (ROC) curve analysis identified the optimal lactate cutoff (4.2 mmol/L) for predicting 3-day mortality.
• Statistical analyses (Chi-square, t-tests, Mann-Whitney, logistic regression) compared groups and assessed correlations.

Main Results:

• A plasma lactate concentration above 4.2 mmol/L was the best predictor of death within the first 3 days of life.
• Newborns with lactate levels > 4.2 mmol/L had lower birth weight and a higher incidence of being small for gestational age.
• This group also experienced significantly higher rates of seizures, intracranial hemorrhage, and early neonatal death.

Conclusions:

• Plasma lactate concentrations exceeding 4.2 mmol/L in the first 6 hours of life are significantly associated with increased early neonatal mortality.
• Elevated lactate levels correlate with higher frequencies of neurological morbidity and adverse growth parameters (small for gestational age).
• Early measurement of plasma lactate may aid in identifying neonates at high risk for adverse outcomes.