ABSTRACT
Umbilical cord blood levels of lactate, base deficit, and pH were measured in 452
liveborn infants. In vigorous newborns, the mean umbilical arterial and venous concentrations
of lactate were lowest with elective cesarean section, higher with cesarean section
performed during labor, and highest with vaginal delivery (P < .001). This suggests
a rise in the fetal lactate level in response to labor. However, there was no concomitant
increase in the mean umbilical arteriovenous lactate differences, indicating that
both fetus and placenta increase their lactate production proportionately with labor.
Depressed newborns had higher umbilical lactate levels than vigorous newborns irrespective
of the method of delivery (P < .001). Depressed newborns also had a higher mean umbilical
arteriovenous lactate difference than vigorous newborns (P < .001). This suggests
that, under conditions that lead to neonatal depression, the fetus is the major source
of the increased lactate produced, with a smaller contribution from the placenta.
The fetal lactate level may be a good indicator of fetal stress in labor.
