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Umbilical cord arterial blood lactate dehydrogenase and pH as predictors of perinatal outcome in high-risk term pregnancies: A cohort study

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Figure 1

Receiver operating characteristic (ROC) curves plotting the sensitivity and specificity of the umbilical cord arterial blood lactate dehydrogenase and pH values in the prediction of early neonatal mortality
Receiver operating characteristic (ROC) curves plotting the sensitivity and specificity of the umbilical cord arterial blood lactate dehydrogenase and pH values in the prediction of early neonatal mortality

Association between umbilical cord arterial blood pH, lactate dehydrogenase levels and overall neonatal outcome

Parameter Neonatal resuscitation NICU admission Early neonatal complications Early neonatal death
Yes No Yes No Yes No Yes No
Cord blood pH <7.2 66(44.6% ) 82(55.4%) 100(67.6 %) 48(32.4% ) 79(53.4%) 69(46.6%) 15(10.1 %) 133(89.9% )
≥7.2 9(5.9%) 143(94.1 %) 15(9.9%) 137(90.1 %) 11(7.2%) 141(92.8 %) 1(0.7%) 151(99.3% )
Chi-square value 59.82 105.61 76.02 13.34
p-value 0.000 0.000 0.000 0.000
Cord blood <612 6(3.2%) 182(96.8 %) 14(7.4%) 174(92.6 %) 9(4.8%) 179(95.2 %) 0(0%) 188(100%)
LDH (U/L) ≥612 69(61.6% ) 43(38.4%) 101(90.2 %) 11(9.8%) 81(72.3%) 31(27.7%) 16(14.3 %) 96(85.7%)
Chi-square value 127.74 203.22 152.43 28.37
p-value 0.000 0.000 0.000 0.000

Participant Characteristics

Parameter Number (n) Percentage
MATERNAL AGE (years)
19–20 7 2.3%
21–30 232 77.3%
31–40 61 22.3%
GRAVIDITY
G1 62 20.7%
G2 91 30.3%
G3 86 28.7%
G4 38 12.7%
≥ G5 23 7.7%
PARITY
0 92 30.7%
1 113 37.7%
2 81 27.0%
≥3 14 4.7%
GESTATIONAL AGE (WEEKS)
>37– ≤39 167 55.7%
>39– ≤41 40 40%
>41– ≤42 13 4.3%
MODE OF DELIVERY
Normal vaginal delivery 133 44.3%
Emergency lower-segment caesarean section 75 25.0%
Elective lower-segment caesarean section 42 14.0%
Instrumental delivery 47 15.7%
Breech-assisted vaginal delivery 3 1.0%
NEONATAL GENDER
Male 164 54.7%
Female 136 45.3%
NEONATAL BIRTH WEIGHT (KG)
≥1.5–≤2.5 34 11.3%
>2.5–≤3.5 253 84.3%
≥3.5 13 4.3%
NEONATAL OUTCOME
Survived 284 94.7%
Early neonatal death 16 5.3%

Association between mode of delivery, Apgar scores, cord blood pH and LDH levels

Parameter Normal vaginal delivery Emergency LSCS* Elective LSCS* Instrumental delivery Assisted breech delivery Total Chi- square value P value
1-min Apgar score
<7 14(15.2%) 41(44.6%) 4(4.3%) 31(33.7%) 2(2.2%) 92(30.7%) 83.88 0.000
>7 119(57.2%) 34(16.3%) 38(18.3%) 16(7.7%) 1(0.5%) 208(69.3%)
5-min Apgar score
<7 0(0%) 5(62.5%) 0(0%) 2(25%) 1(12.5%) 8(2.7%) 20.75 0.000
>7 133(45.5%) 70(24.0%) 42(14.4%) 45(15.4%) 2(0.7%) 292(97.3%)
Cord arterial blood pH
<7.2 37(25.0%) 51(34.5%) 16(10.8%) 42(28.4%) 2(1.4%) 148(49.3%) 67.69 0.000
≥7.2 96(63.2%) 24(15.8%) 26(17.1%) 5(3.3%) 1(0.7%) 152(50.7%)
Cord arterial blood LDH
<612U/L 112(59.6%) 30(16.0%) 35(18.6%) 9(4.8%) 2(1.1%) 188(62.7%) 88.59 0.000
≥612U/L 21(18.8%) 45(40.2%) 7(6.3%) 38(33.9%) 1(0.9%) 112(37.3%)