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

<b>Objective:</b> To investigate the ability of small-for-gestational-age (SGA) fetuses to develop lacticemia during hypoxia. <b>Methods:</b> Umbilical cord arterial and venous pH, lactate and glucose concentrations were determined in 1777 SGA (&lt;10th percentile) and 14,569 AGA newborns and related to acidemia (pH p <b>Results:</b> 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. <b>Conclusions:</b> 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.