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 and eighty-seven neonates (187) had high arterial lactate levels. The following factors were associated with an increased likelihood of high lactate concentration: male sex (adjusted OR (aOR)=1.71; 95% CI 1.16 to 2.54; p<0.05), primigravidity (aOR=2.78; 95% CI 1.89 to 4.08; p<0.001), meconium-stained liquor (aOR=5.85; 95% CI 4.08 to 8.47; p<0.001) and administration of oxytocin (aOR=1.97; 95% CI 1.00 to 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.