Umbilical artery lactate levels and associated maternal and newborn characteristics at Mulago National Referral Hospital: A cross-sectional observational study

Objective: To determine the maternal and newborn characteristics
associated with high umbilical artery lactate levels at Mulago National
Referral Hospital. Design: Cross-sectional observational study. Setting:
Department of Obstetrics and Gynecology at a national referral hospital
located in the capital of Uganda, Kampala. Participants: We randomly
selected 720 pregnant mothers at term who presented in labour and their
newborn babies. Primary outcome: Umbilical artery lactate level. Results:
During the study, there were 579 vaginal deliveries (18 instrumental) and
141 caesarean sections which met the inclusion criteria. One hundred
eighty seven neonates (187) had high arterial lactate levels. The
following factors were associated with an increased likelihood of high
lactate concentration: male sex (aOR = 1.71; 95%CI 1.16–2.54;
P<0.05), primigravidity (aOR = 2.78; 95%CI 1.89-4.08; P <
0.001), Meconium stained liquor (MSL) (aOR = 5.85; 95%CI 4.08-8.47;
P<0.001) and, Administration of oxytocin (aOR = 1.97; 95%CI
1.00-3.77; P<0.05). Conclusion: About a fifth of the babies born in
Mulago national referral hospital during the study period had high
umbilical artery lactate. The maternal-fetal factors significantly
associated with high umbilical artery lactate levels included: baby’s sex,
mother’s gravidity, meconium stained amniotic fluid, and oxytocin
administration during labour.