Umbilical Cord Blood Biomarkers as Predictors of Meconium Aspiration Syndrome: A Prospective Cohort Study

Abstract

Background: Early identification of neonates at risk of meconium aspiration syndrome (MAS) may facilitate timely monitoring and respiratory support.

Objective: To evaluate umbilical cord-blood lactate and acid–base parameters for predicting MAS among neonates born through meconium-stained amniotic fluid.

Methods: This prospective cohort study included 72 neonates. Cord-blood pH, PCO₂, PO₂, bicarbonate, oxygen saturation, base excess, and lactate were measured immediately after delivery. Neonates were followed for development of MAS, respiratory-support requirements, and in-hospital outcome.

Results: MAS developed in 19 neonates (26.4%). Compared with non-MAS neonates, affected neonates had higher lactate (5.40 vs 2.60 mmol/L), lower bicarbonate (15.03 vs 22.18 mEq/L), more negative base excess (−10.76 vs −4.57 mEq/L), and lower 1- and 5-minute Apgar scores (all p<0.001). Cord-blood pH, PCO₂, PO₂, and oxygen saturation did not differ significantly. Lactate showed the highest discrimination for MAS (AUC 0.81), followed by pH (0.75) and base deficit (0.71).

Conclusion: Cord-blood lactate may be a useful early adjunct for predicting MAS.