Analysis Of Influencing Factors Of Early Lactate Level In Newborns

Objective:To analyze the influencing factors of early blood lactate level in newborns by collecting blood lactate value and relevant clinical data of newborns in our hospital,and provide evidences for clinicians to judge the condition of ill children with blood lactate level.Methods:Newborn infants in the pediatric neonatal ward of the First Affiliated Hospital of Kunming Medical University from November 2018 to October 2019 were collected as the research objects.The blood lactate level was required to be measured within one hour after birth,and grouped:1.The newborn infants were divided into normal lactate group(lactate value<2.0 mmol/L group)and elevated lactate group(lactate value?2.0 mmol/L group)according to the threshold value of blood lactate,The general data,disease occurrence,neonatal critical illness scores(NCIS)and maternal pregnancy data in the two groups were compared,and the correlation was analyzed.2.The ill children were divided into non-critical group,critical group and extremely critical group according to the neonatal critical illness scores,the blood lactate among three groups and the correlation between blood lactate and score were analyzed,and the linear regression equation was established to calculate the predicted value of death.3.The correlation between early blood lactate level and disease occurrence and risk factors in high-risk infants were analyzed.All data were analyzed by SPSS 24.0 statistical software,and P<0.05 was statistically significant.Results:1.A total of 907 neonates met the inclusion criteria,158 cases in normal lactate group and 749 cases in increased lactate group;There were statistically significant differences in 1 minute Apgar score,5 minute Apgar score,neonatal critical illness scores,umbilical cord artery blood pH value,blood gas pH value,meconium-staind amniotic fluid,placenta previa/placental abruption,umbilical cord around the neck/umbilical cord twist,neonatal asphyxia,transient tachypnea of the newborn(TTN),intrauterine distress,NRDS,meconium aspiration syndrome(MAS)between the two groups(P<0.05).2.There were 793 cases in non-critical group,107 cases in critical group and 7 cases in extremely critical group,There was a statistically significant difference in blood lactate levels among the three groups(P<0.05).The blood lactate level was linearly related to the NCIS score(pearson correlation coefficient r=-0.58,P<0.05),when the blood lactate level was less than 5.5 mmol/L,5.5 to 11.52 mmol/L and more than 11.52 mmol/L,the incidences of mortality was 0.00%,1.4%,23.8%,the difference was Statistical significant(P<0.05).3.Binary multivariate logistic regression analysis showed that the 1 minute Apgar score,umbilical cord artery blood pH value,neonatal asphyxia were risk factors of neonatal early hyperlactatemia.4.There was no correlation between early blood lactate level of high-risk infants and early onset neonatal bacterial infection,hyperbilirubinemia of newborn(spearman correlation coefficient r=0.118,0.104,P>0.05),and it was correlated with gestational hypertension,mother prenatal fever,meconium-staind amniotic fluid,umbilical cord around the neck/umbilical cord twist(spearman correlation coefficient r=0.211,0.325,0.221,0.255,P<0.05).Conclusion:1.Perinatal hypoxia is the main reason of the elevated early lactate in newborns.2.Blood lactate level provides the reliable basis in the severity and prognosis of neonatal critical cases,and has certain predictive value for neonatal death.