Correlation of Apgar score, cord blood pH, and lactate with severity of birth asphyxia in a tertiary care hospital: A cross-sectional observational study

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Background: A wide variety of clinical parameters and laboratory tests is employed to diagnose perinatal asphyxia such as Apgar score, umbilical arterial acidemia/base excess, intrapartum electronic fetal monitoring, fetal scalp pH measurement, and presence of meconium in amniotic fluid. Methodology: The current multicentric, cross-sectional observational study was conducted in neonatal intensive care unit of Department of Pediatrics, Military Hospital Jammu and RPGMC Tanda. The study population included term neonates with evidence of birth asphyxia. The quantitative data were represented as their mean ± standard deviation categorical and nominal data were expressed in percentage. The t -test was used for analyzing quantitative data, or else nonparametric data were analyzed by the Mann–Whitney test and categorical data were analyzed using Chi-square test. Results: Out of 115 babies with low APGAR (<7) at 1 min, the mean APGAR score was 5.09 with no hypoxic-ischemic encephalopathy (HIE) and 3.56 with HIE, mean cord blood pH levels were 7.29 with no HIE and 7.11 with HIE. Mean cord blood lactate was 5.8 with no HIE and 2.91 with HIE. The severity of HIE was also associated with low APGAR, low pH values, and higher lactate levels in cord blood. Conclusion: Umbilical cord blood parameters such as pH < 7.1, low APGAR (<5), and high lactate levels (>5 mmol/l) were significantly associated with perinatal asphyxia and its severity.

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