Umbilical cord arterial blood pH versus lactate for prediction of early neonatal outcomes in high-risk term newborns: A hospital-based observational study
4 affiliations
- 1Post Graduate Resident, Department of Paediatrics, Government Medical College, Haldwani, Uttarakhand, India
- 2Professor and Head, Department of Paediatrics, Government Medical College, Haldwani, Uttarakhand, India
- 3Assistant Professor, Department of Paediatrics, Government Medical College, Haldwani, Uttarakhand, India
- 4Senior Resident, Department of Community Medicine, World College of Medical Sciences and Research, Jhajjar, Haryana, India
Abstract
Background: Umbilical cord arterial pH is widely used to assess fetal acidemia, while lactate may provide a direct indicator of anaerobic metabolism. Aims and Objectives: This study compared the diagnostic performance of cord arterial pH and lactate for predicting adverse early neonatal outcomes in high-risk term newborns. Materials and Methods: This hospital-based cross-sectional observational study included 296 high-risk term newborns delivered at ≥37 completed weeks. Umbilical cord arterial blood was collected immediately after birth and analyzed for pH and lactate. Newborns were followed until hospital discharge or death. The primary outcome was a composite adverse early neonatal outcome comprising special newborn care unit admission, treated hypoglycemia, delayed attainment of full feeds, convulsions, hypoxic-ischemic encephalopathy, or neonatal death. Diagnostic performance was assessed using validity and receiver operating characteristic (ROC) analyses, and independent predictors were evaluated using multivariable logistic regression. Results: A composite adverse outcome occurred in 92 (31.1%) newborns. Mean cord arterial pH was 7.24±0.09 and mean lactate was 4.9±2.2 mmol/L. Lactate >4.8 mmol/L showed sensitivity of 84.3% and negative predictive value of 90.0%, whereas pH <7.15 showed specificity of 86.2% and positive predictive value of 75.8%. ROC analysis showed area under the curve of 0.91 for lactate and 0.86 for pH. Cord arterial pH <7.20 and lactate ≥6.0 mmol/L were independently associated with adverse outcomes. Conclusion: Both biomarkers were associated with adverse early neonatal outcomes. Lactate demonstrated higher sensitivity and overall discriminative performance, while pH showed higher specificity. Their combined interpretation may support early neonatal risk stratification.
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BibTeX
@article{chauhan2026umbilical,
title = {{Umbilical cord arterial blood pH versus lactate for prediction of early neonatal outcomes in high-risk term newborns: A hospital-based observational study}},
author = {Ela Chauhan and Ritu Rakholia and Pooja Agarwal and Prerna Chamoli and Jatin Prajapati},
journal = {Asian Journal of Medical Sciences},
year = {2026},
month = nov,
doi = {10.71152/ajms.v17i11.5621},
url = {https://doi.org/10.71152/ajms.v17i11.5621},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Umbilical cord arterial blood pH versus lactate for prediction of early neonatal outcomes in high-risk term newborns: A hospital-based observational study
AU - Ela Chauhan
AU - Ritu Rakholia
AU - Pooja Agarwal
AU - Prerna Chamoli
AU - Jatin Prajapati
PY - 2026
DA - 2026/11/01
JO - Asian Journal of Medical Sciences
DO - 10.71152/ajms.v17i11.5621
UR - https://doi.org/10.71152/ajms.v17i11.5621
AB - Background: Umbilical cord arterial pH is widely used to assess fetal acidemia, while lactate may provide a direct indicator of anaerobic metabolism. Aims and Objectives: This study compared the diagnostic performance of cord arterial pH and lactate for predicting adverse early neonatal outcomes in high-risk term newborns. Materials and Methods: This hospital-based cross-sectional observational study included 296 high-risk term newborns delivered at ≥37 completed weeks. Umbilical cord arterial blood was collected immediately after birth and analyzed for pH and lactate. Newborns were followed until hospital discharge or death. The primary outcome was a composite adverse early neonatal outcome comprising special newborn care unit admission, treated hypoglycemia, delayed attainment of full feeds, convulsions, hypoxic-ischemic encephalopathy, or neonatal death. Diagnostic performance was assessed using validity and receiver operating characteristic (ROC) analyses, and independent predictors were evaluated using multivariable logistic regression. Results: A composite adverse outcome occurred in 92 (31.1%) newborns. Mean cord arterial pH was 7.24±0.09 and mean lactate was 4.9±2.2 mmol/L. Lactate >4.8 mmol/L showed sensitivity of 84.3% and negative predictive value of 90.0%, whereas pH <7.15 showed specificity of 86.2% and positive predictive value of 75.8%. ROC analysis showed area under the curve of 0.91 for lactate and 0.86 for pH. Cord arterial pH <7.20 and lactate ≥6.0 mmol/L were independently associated with adverse outcomes. Conclusion: Both biomarkers were associated with adverse early neonatal outcomes. Lactate demonstrated higher sensitivity and overall discriminative performance, while pH showed higher specificity. Their combined interpretation may support early neonatal risk stratification.
SN - 2467-9100
SN - 2091-0576
ER -