title: The small-for-gestational-age fetus has an intact ability to develop lacticemia when exposed to hypoxia: a retrospective comparative register study.
abstract: OBJECTIVE
  To investigate the ability of small-for-gestational-age (SGA) fetuses to develop lacticemia during hypoxia.
  
  
  METHODS
  Umbilical cord arterial and venous pH, lactate and glucose concentrations were determined in 1777 SGA (<10th percentile) and 14,569 AGA newborns and related to acidemia (pH < mean -2SD). Non-parametric statistics with two-sided p < .05 were considered significant.
  
  
  RESULTS
  Glucose and lactate were linearly related and both variables correlated negatively with pH. Glucose was equal in SGA and AGA at a normal pH, but at severe acidemia it was lower in SGA. Glucose was higher in both groups during acidemia. Lactate was higher in SGA at both a normal and a low pH, and in both groups lactate increased progressively with the severity of acidemia.
  
  
  CONCLUSIONS
  In both SGA and AGA fetuses, glucose was mobilized during acidemia; lactate was higher in SGA at both a normal and low pH. Considering SGA being a proxy for fetal growth restriction, and acidemia a proxy for hypoxia, it is concluded that growth-restricted fetuses have an intact ability to develop lacticemia during hypoxia.
authors.affiliation: a Department of Obstetrics and Gynecology , Institution of Clinical Sciences, Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Åkerman
authors.affiliation: a Department of Obstetrics and Gynecology , Institution of Clinical Sciences, Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Parisa
authors.initials: P
authors.lastname: Mokarami
authors.affiliation: b Center for Reproductive Epidemiology, Tornblad Institute, Lund University , Lund , Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Källén
authors.affiliation: a Department of Obstetrics and Gynecology , Institution of Clinical Sciences, Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Per
authors.identifier: http://orcid.org/0000-0002-0792-1393
authors.initials: P
authors.lastname: Olofsson
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005317:Fetal Growth Retardation / Q000378:metabolism; D005311:Fetal Hypoxia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D065906:Hyperlactatemia / Q000097:blood / Q000209:etiology*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D019344:Lactic Acid / Q000097:blood*; D011247:Pregnancy; D012189:Retrospective Studies; D014469:Umbilical Arteries
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019344:Lactic Acid
keywords: Cord blood; IUGR; SGA; glucose; growth restriction; hypoxia; lactate