ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2025
Evaluating predictive values of umbilical cord arterial lactate for adverse newborn outcomes among term-births in northern Uganda: A cross sectional analytical study.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- (De)coding perinatal deaths: applying the International Classification of Diseases to perinatal mortality to a perinatal e-registry from 16 hospitals in Benin, Malawi, Tanzania, and Uganda.Global health action · 2026Article
- A multi-faceted hospital-based intervention for intrapartum care in sub-Saharan Africa: a stepped-wedge cluster-randomized trial.Nature medicine · 2026Article
- Prevalence and risk of adverse intrapartum-related outcomes in Uganda: a cross-sectional study with nested case-control.BMJ open · 2025Article
- Evaluating predictive values of umbilical cord arterial lactate for adverse newborn outcomes among term-births in northern Uganda: A cross sectional analytical study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
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Abstract
objectiveBirth asphyxia is one of the leading causes of death for neonates worldwide. Lack of an objective cost effective test to predict poor newborn outcomes at birth affects the ability to respond appropriately. This study determined predictive values of umbilical cord arterial lactate in relation to adverse neonatal outcomes.
methodsThis was a cross-sectional analytical study conducted between March 2018 and March 2019 at two hospitals in Northern Uganda. A total of 2655 women admitted for birth and their newborns were recruited. At birth, umbilical cord arterial blood was tested for lactate using the Nova Biomedical StatStrip Xpress meter. Apgar scores were assessed at 5 min by trained research midwives. Area under the receiver operator characteristics curve (AUROC) was calculated relating umbilical arterial lactate (UAL) levels and four outcomes. We modeled the best lactate cutoff level associated with the highest AUROC for the four outcomes.
resultsThe estimated AUROC for lactate was: 88.42% for Apgar score <7 at 5 min, 83.35% for resuscitation with bag and mask, 84.55% for oxygen therapy after resuscitation and 87.72% for admission to neonatal care unit. The UAL cutoff value of 5.5 mmol/L was associated with the best AUROC of between 75.81% to 81.75% for the four adverse outcomes with no significant differences when adjusted for infectious disease parameters. The sensitivity, specificity, PPV, and NPV were; 78.95%, 86.48%, 23.54%, and 98.73% for Apgar scores <7 at 5 min, 64.40%, 88.11%, 36.59%, and 95.87% for resuscitation with bag and mask, 67.17%, 87.20%, 30.23%, and 96.99% for oxygen therapy after resuscitation, and 77.17%, 86.15%, 22.27%, and 98.65% for admission to the special care unit, respectively.
conclusionUmbilical cord lactate point-of-care (POC) estimate of ≥5.5 mmol/L predicts adverse neonatal outcomes. This test may be used to trigger early interventions and intensified neonatal care complementing the clinical Apgar score assessment in settings like Uganda.
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