LACTATE, LACTATE PYRUVATE RATIO AND CATECHOLAMINE INTERRELATIONS IN CORD-BLOOD AT DELIVERY IN COMPLICATED PREGNANCIES/

The interrelationships between lactate, lactate/pyruvate (LIP) ratio a nd catecholamines (CA) in cord artery and vein blood were studied in 5 6 pregnancies who had complications in the antenatal period or during labour. This group of babies had higher CA levels and were more acidae mic than fetuses after normal pregnancies and labour. There were stron ger correlations between lactate and noradrenaline (NA) (R = 0.56, P < 0.001), adrenaline (A) (R = 0.41, P = 0.002) and dopamine (DA) (R = 0 .42, P = 0.001) in cord artery blood, than previously reported for nor mal deliveries. Correlations between LIP ratio and CAs were also signi ficant, although weaker. Multiple regression analysis, using cord arte ry lactate as the dependent variable, revealed significant correlation s for pH (P = 0.01) and pyruvate (P < 0.001), but not for the CAs. The subgroups with high lactate (> 75th centile) had significantly higher NA (P=0.007) and DA (P<0.001) in cord artery and NA (P<0.001) and A ( P<0.001) in cord vein blood, as compared with the subgroup who had low er lactate concentrations. We conclude that fetal hypoxia induces feta l CA production as well as anaerobic metabolism with lactate productio n. However, the adrenergic stimulation seems not to contribute signifi cantly to the fetal lactate production. (C) 1998 Elsevier Science Irel and Ltd. All rights reserved.