The small-for-gestational-age fetus has an intact ability to develop lacticemia when exposed to hypoxia: a retrospective comparative register study

Abstract

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.

Keywords:

• Cord blood
• glucose
• growth restriction
• hypoxia
• IUGR
• lactate
• SGA

Acknowledgements

Ethical approval: The study was approved 25 May 2009 by the Regional Ethical Review Board, Lund, Sweden (reference number 2009/222).

Disclosure statement

The authors state explicitly that there are no conflicts of interest in connection with this article.

Additional information

Funding

This study was supported by grants from Region Skåne and the Medical Faculty at the Lund University (ALF). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.