Normal Range for Maternal Lactic Acid during Pregnancy and Labor: A Systematic Review and Meta-Analysis of Observational Studies

Bauer, Melissa E.; Balistreri, Michael; MacEachern, Mark; Cassidy, Ruth; Schoenfeld, Robert; Sankar, K. Nathan; Clauw, Daniel J.; Langen, Elizabeth S.

doi:10.1055/s-0038-1675243

Cited by 22 publications

(12 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maternal blood lactate and pyruvate levels are also relatively consistent across trimester 3. 87, 88 Further, error in measurement introduced by single samples would tend to bias estimates towards the null. While, for most mothers, phthalate urinary metabolites were measured later in trimester 3 than the maternal serum metabolites, adjustment for this time interval had little effect and the strength of association between phthalate levels and pathway scores did not materially differ by time interval between serum and urine measures.…”

Section: Discussionmentioning

confidence: 99%

Increased maternal non-oxidative energy metabolism mediates association between prenatal DEHP exposure and offspring ASD symptoms: a birth cohort study

Thomson

Drummond

O’Hely

et al. 2022

Preprint

View full text Add to dashboard Cite

Prenatal phthalate exposure has previously been linked to the development of autism spectrum disorder (ASD). However, the underlying biological mechanisms remain unclear. We investigated whether maternal and child central carbon metabolism is involved as part of the Barwon Infant Study, a population-based birth cohort of 1074 Australian children. We estimated phthalate daily intakes using third-trimester urinary phthalate metabolite concentrations and other relevant indices. The metabolome of maternal serum in the third trimester, cord blood at birth and child plasma at 1 year were measured by nuclear magnetic resonance. We used the Small Molecule Pathway Database and principal component analysis to construct composite metabolite scores reflecting metabolic pathways. ASD symptoms at 2 and 4 years were measured by subscales of the Child Behavior Checklist and the Strengths and Difficulties Questionnaire, respectively. Multivariable linear regression analyses demonstrated (i) associations between higher prenatal di(2-ethylhexyl) phthalate (DEHP) levels and increased activity in maternal non-oxidative energy metabolism pathways, specifically non-oxidative pyruvate metabolism and the Warburg Effect, and (ii) associations between increased activity in these pathways and increased offspring ASD symptomology at 2 and 4 years of age. Mediation analyses suggested that part of the mechanism by which higher prenatal DEHP exposure influences the development of ASD symptoms in early childhood is through a maternal metabolic shift in pregnancy towards non-oxidative energy pathways, which are inefficient compared to oxidative metabolism. Interventions targeting maternal metabolic activity in pregnancy may be beneficial in reducing the potential risk to the developing fetus.

show abstract

Section: Discussionmentioning

confidence: 99%

Increased maternal non-oxidative energy metabolism mediates association between prenatal DEHP exposure and offspring ASD symptoms: a birth cohort study

Thomson

Drummond

O’Hely

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A systematic review and meta‐analysis of observational studies by Bauer et al 25 reported that the maternal concentration of serum lactate outside of labor was less than 2 mmol/L, and that during labor periods, the range was higher than 2 mmol/L. While the pooled ranges were less than 4 mmol/L, few individual studies reported ranges higher than 4 mmol/L during labor.…”

Section: Discussionmentioning

confidence: 99%

Early prognostic capacity of serum lactate for severe postpartum hemorrhage

Kway

Castillo-Reyther

Domínguez-Salgado

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To evaluate whether the concentration of serum lactate during the diagnosis of postpartum hemorrhage (bleeding ≥500 mL during labor or ≥1000 mL during cesarean delivery) predicts severe hemorrhage (SPPH; blood loss ≥1500 mL at end of labor or in the following 24 h). Methods A prospective cohort pilot study was conducted of women with a vaginal or cesarean delivery from February 2018 to March 2019 who presented with bleeding ≥500 mL measured by the gravimetric method in a reference hospital in San Luis Potosi, Mexico. Venous blood samples were taken for analysis of serum lactate. A receiver operating characteristic curve determined the serum lactate threshold value for SPPH and χ2 test assessed the difference in serum lactate elevation between SPPH and non‐SPPH groups. Lastly, the prognostic capacity between the thresholds was compared. Results SPPH developed in 43.33% of the 30 women in the study group. The best prognostic threshold was 2.68 mmol/L of serum lactate (odds ratio [OR] 17.88, 95% confidence interval [CI] 2.7–16.8, P < 0.001); sensitivity was 0.85 (95% CI 0.55–0.98); specificity was 0.76 (95% CI 0.50–0.93). Conclusion Serum lactate may be a useful prognostic marker for SPPH, more studies are needed to validate these findings.

show abstract

“…20 While venous lactic acid levels can be used as a screening tool for infection in pregnant women, elevations may be seen during labor, especially later in labor when there is maximal skeletal muscle contraction. 21 Therefore, lactate alone may not be a reliable marker for the detection of infection at the time of intrapartum fever.…”

Section: The Road Map Forwardmentioning

confidence: 99%

Innovating Evaluation and Treatment of Intrapartum Fevers: Where Do We Go from Here?

et al. 2021

View full text Add to dashboard Cite

As intrapartum fevers are not always infectious in origin, determining whether antibiotics are indicated is challenging. We previously sought to create a point-of-care calculator using clinical data available at the time of an intrapartum fever to identify the subset of women who require antibiotic treatment to avoid maternal and neonatal morbidity. Despite the use of a comprehensive dataset from our institutions, we were unable to propose a valid and highly predictive model. In this commentary, we discuss why our model failed, as well as future research directions to identify and treat true intraamniotic infection. Developing a risk-stratification model is paramount to minimizing maternal and neonatal exposure to unnecessary antibiotics while allowing for early identification of women and babies at risk for infectious morbidity. Key Points

show abstract

Normal Range for Maternal Lactic Acid during Pregnancy and Labor: A Systematic Review and Meta-Analysis of Observational Studies

Cited by 22 publications

References 37 publications

Increased maternal non-oxidative energy metabolism mediates association between prenatal DEHP exposure and offspring ASD symptoms: a birth cohort study

Increased maternal non-oxidative energy metabolism mediates association between prenatal DEHP exposure and offspring ASD symptoms: a birth cohort study

Early prognostic capacity of serum lactate for severe postpartum hemorrhage

Innovating Evaluation and Treatment of Intrapartum Fevers: Where Do We Go from Here?

Contact Info

Product

Resources

About