The Role of Plasma Lactate Dehydrogenase Testing in the Prediction of Severe Conditions in Newborn Infants: A Prospective Study

Abstract

Purpose: Plasma lactate dehydrogenase (LDH) is an indicator of body tissue hypoxia. This study aimed to determine the relationship between plasma lactate dehydrogenase concentrations and severe conditions in newborn infants. Patients and Methods: A cross-sectional study was performed on newborn infants who were admitted to the newborn care unit at Hue University hospital from April 2016 to May 2017 in the early neonatal period (within 12 hours postpartum). Plasma LDH was measured at the time of admission and correlated to clinical conditions. Results: In 275 newborn infants, plasma LDH levels in the term infants were significantly higher than that in the preterm infants [751 (IQR: 602–922) vs 594 (IQR: 496.75–767.25), p=0.0006]. There was a relationship between the signs of feeding problems, tachypnea, and cyanosis with plasma LDH levels (p < 0.01). Infants with asphyxia had significantly higher LDH values than the non-asphyxia group [756 (640–1110) vs 712 (576–882.25) p=0.0289]. Infants with early-onset neonatal sepsis had significantly higher LDH values than those without early-onset neonatal sepsis [755.5 (IQR: 645–960.5) vs 707 (IQR: 562.25–881.25) p=0.0035]. Infants with respiratory distress requiring continuous positive airway pressure (CPAP) had significantly higher LDH values than those with illnesses not requiring CPAP [903 (IQR: 628.75–1285.25) vs 719 (IQR: 576.5–882) p=0.0421]. By using multivariate regression analysis, we found a significant multifactorial correlation between gestational age, early-onset neonatal sepsis, asphyxia, and respiratory distress requiring CPAP with plasma LDH levels (p <0.05). Conclusion: Plasma LDH level can be a good marker for the prognosis of severe conditions in newborn infants, including early-onset neonatal sepsis, asphyxia, and respiratory-distress.