Umbilical Cord Unbound Free Fatty Acid Concentration and Low Apgar Score

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Abstract
Increased levels of unbound Free Fatty acid (FFAu) have been found in adults undergoing coronary angioplasty as a result of acute hypoxia-ischemia. We hypohesized that infants suffering from a 1-minute Apgar score of less than 5 will demonstrate elevated FFAu levels in the cord blood. One hundred ninety-nine infants between 25 and 41 weeks gestational age were enrolled in the study. Infants with an Apgar score of less than 5 at 1 minute served as the study group. Blood samples were collected from the umbilical cord and serum FFAu levels were measured with the fluorescent probe acrylodan-derivatized intestinal fatty acid binding protein. The low Apgar score group (n = 32, birthweight 3153 ± 780 g, gestational age 37.9 ± 3.1 weeks) and normal Apgar score group (n = 167, birthweight 3067 ± 847 g, gestational age 37.5 ± 3.5 weeks) were significantly different with respect to Apgar score at 1 minute (3.0 ± 1.2 versus 8.4 ± 1.1), Apgar score at 5 minutes (6.9 ± versus 8.9 ± 0.5), cord pH (7.16 ± 0.12 versus 7.28 ± 0.07), and in the frequency of meconium passage (40.6% versus 14.9%). Cord FFAu levels were 4.4 ± 1.7 versus 3.2 ± 1.2 nM (p < 0.001), respectively. Cord FFAu correlated inversely with Apgar score at 1 minute (r = -0.31, p < 0.05) and with cord pH (r = -0.12, p < 0.05), but not with birthweight or gestational age. In infants with low 1-minute Apgar scores, cord free fatty acid levels were significantly elevated compared with those from controls.

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