Lactic Dehydrogenase in Umbilical Cord Blood in Healthy Infants after Different Modes of Delivery

Eva Wiberg-Itzel, Hampus Josephson, Nana Wiberg, Linus Olson, Birger Winbladh and Mathias Karlsson

Background: LDH may be a valuable marker for some of the most important diseases in newborns, and umbilical cord blood is a non-invasive and easy way to obtain blood for analysis. Aims of this study were to define interval for LDH in arterial and venous cord blood at delivery in truly healthy newborns.
Method: a prospective observational study was performed at Soder Hospital, Stockholm, Sweden during 2011-2012. Umbilical cord blood was collected at delivery, and value of LDH was analysed in 549 healthy infants >37 weeks of gestation, born after an uncomplicated pregnancy from a healthy mother.
Results: The 2.5th and 97.5th percentile for arterial LDH was 162-612 u/L and 252-636 u/L for venous LDH. Instrumental delivery and acute caesarian section showed significantly higher intervals and elective caesarian section significantly lower than vaginal delivery. Haemolysis (>0.3g/l) disqualified a 13-41% of the samples. Conclusion: Reported LDH levels are in accordance with earlier studies and appear to be a sensitive marker for intrapartal stress factors. The absence of an arterial/venous difference makes the sampling of cord blood easier but frequent haemolysis is a problem when using the standard method of analyses.