Cord Length, Umbilical Artery Lactate Concentration and Perinatal Outcomes of Babies with Nuchal Cord at Ile-Ife, Nigeria


  • IO Awowole
  • OO Badejoko
  • OA Adeniyi
  • BO Badejoko
  • OO Sowemimo
  • HC Anyabolu
  • TA Adedeji



Background: There is inconclusive evidence on the relevance of the nuchal cord in obstetric practice.

Objectives: This study aims to evaluate the umbilical artery lactate concentration and perinatal outcomes of babies born with a nuchal cord.

Methods: In a cross-sectional study at the Obafemi Awolowo University Teaching Hospital, babies born with a nuchal cord at term and matched controls without a nuchal cord were recruited between January 2017 and December 2018. Gestational age at delivery, meconium-stained liquor, foetal heart rate abnormalities, Caesarean section rates, cord lengths and umbilical artery lactate concentrations were compared. The umbilical artery lactate concentration was assayed with the Lactate-Plus®; neonatal acidosis was defined as cord lactate concentration > 4.9mmol/L.

Results: One hundred and forty-four babies with nuchal cords and 144 controls were recruited. The prevalence of nuchal cord was 3.4%, with 80% of the babies having a single loop. Babies with nuchal cords had longer mean cord length (57.7cm vs 45.4cm; p<0.01), higher mean umbilical artery lactate (4.93mmol/L vs 3.48mmol/L; p = 0.04), meconium-stained liquor (16% vs 3.2%; Relative risk = 4.6), more babies with  Apgar score <7 at fifth minute (9 versus 4 babies) and increased perinatal mortality (55.5/1000 births vs 13.8/1,000 births; Relative risk = 4). There was a positive correlation between cord length and the number of nuchal loops (r = 0.5, p<0.01).

Conclusions: Nuchal cord is associated with abnormal cord lactate concentration and adverse perinatal outcomes. Prenatal reporting may enhance intrapartum surveillance and improve perinatal outcomes.

Author Biography

OA Adeniyi

Department of Obstetrics and Gynaecology,


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Original Research