{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:17:34Z","timestamp":1788283054266,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Determination of lactate in fetal scalp blood (FBS) during labour has been recognised since the 1970s. The internationally accepted cutoff of &gt;4.8\u2009mmol\/l indicating fetal acidosis is exclusive for the point\u2010of\u2010care device (POC) LactatePro\u2122, which is no longer in production. The aim of this study was to establish a new cutoff for scalp lactate based on neonatal outcomes with the use of the StatstripLactate<jats:sup>\u00ae<\/jats:sup>\/StatstripXpress<jats:sup>\u00ae<\/jats:sup> Lactate system, the only POC designed for hospital use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>January 2016 to March 2020 labouring women with indication for FBS were prospectively included from seven Swedish and one Australian delivery unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Inclusion criteria: singleton pregnancy, vertex presentation, \u226535<jats:sup>+0<\/jats:sup>\u2009weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Based on the optimal correlation between FBS lactate and cord pH\/lactate, only cases with \u226425\u2009minutes from FBS to delivery were included in the final calculations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Metabolic acidosis in cord blood defined as pH &lt;7.05 plus BD<jats:sub>ecf<\/jats:sub> &gt;10\u2009mmol\/l and\/or lactate &gt;10\u2009mmol\/l.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3334 women were enrolled of whom 799 were delivered within 25\u2009minutes. The areas under the receiver operating characteristics curves (AUC) and corresponding optimal cutoff values were as follows; metabolic acidosis AUC 0.87 (95% CI 0.77\u20130.97), cutoff 5.7\u2009mmol\/l; pH &lt;7.0 AUC 0.83 (95% CI 0.68\u20130.97), cutoff 4.6\u2009mmol\/l; pH &lt;7.05 plus BD<jats:sub>ecf<\/jats:sub> \u226512\u2009mmol\/l AUC 0.97 (95% CI 0.92\u20131), cutoff 5.8\u2009mmol\/l; Apgar score &lt;7 at 5\u2009minutes AUC 0.74 (95% CI 0.63\u20130.86), cutoff 5.2\u2009mmol\/l; and pH &lt;7.10 plus composite neonatal outcome AUC 0.76 (95% CI 0.67\u20130.85), cutoff 4.8\u2009mmol\/l.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A scalp lactate level &lt;5.2\u2009mmol\/l using the StatstripLactate<jats:sup>\u00ae<\/jats:sup>\/StatstripXpress<jats:sup>\u00ae<\/jats:sup> system will safely rule out fetal metabolic acidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Scalp blood lactate &lt;5.2\u2009mmol\/l using the StatstripLactate<jats:sup>\u00ae<\/jats:sup>\/StatstripXpress system has an excellent ability to rule out fetal acidosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16924","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T18:52:55Z","timestamp":1632423175000},"page":"636-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Proposed cutoff for fetal scalp blood lactate in intrapartum fetal surveillance based on neonatal outcomes: a large prospective observational study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5840-4062","authenticated-orcid":false,"given":"L","family":"Iorizzo","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund Lund University Lund Sweden"},{"name":"Department of Obstetrics and Gynaecology Helsingborg Hospital Helsingborg 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Lund University Lund Sweden"},{"name":"Department of Obstetrics and Gynaecology Gold Coast University Hospital Gold Coast Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Wiberg\u2010Itzel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology S\u00f6der Hospital Stockholm Sweden"},{"name":"Institute of Karolinska Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"McGee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Westmead Hospital Sydney NSW Australia"},{"name":"The University of Sydney Sydney NSW 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