Abstract
Introduction: Birth asphyxia and Hypoxic–ischemic encephalopathy (HIE) are significant causes of neonatal mortality and morbidity. Serum sodium, potassium, and calcium level abnormalities may occur in neonates with birth asphyxia, and their early detection and prompt treatment will improve the outcome of these neonates.
 Aim: To study serum electrolyte and calcium levels and their correlation with birth asphyxia and HIE severity.
 Methods: A prospective cross-sectional study was conducted in full-term neonates diagnosed with birth asphyxia, and their serum sodium, potassium, and calcium estimation were done at birth to 12 hours of birth and repeated at 24 to 48 hours of birth. Serum electrolyte and calcium level abnormalities and short-term outcomes of these neonates were studied.
 Results: It was observed that at Apgar score 1 and 5 minutes, with an increase in severity of birth asphyxia serum sodium and calcium levels decreased while potassium levels increased. A significant positive correlation was observed between serum sodium levels and Apgar score at 1 and 5 minutes. Serum calcium levels showed a significant positive correlation with 5 minutes Apgar score. Serum potassium levels at < 12 hours showed a significant negative correlation with 5 minutes Apgar score.
 Conclusion: With increased severity of HIE and Birth asphyxia, serum sodium levels decreased, and serum potassium levels increased. Serum calcium levels decreased with the severity of birth asphyxia but did not decrease their HIE severity.
Highlights
Birth asphyxia and Hypoxic–ischemic encephalopathy (HIE) are significant causes of neonatal mortality and morbidity
Serum calcium levels decreased with the severity of birth asphyxia but did not decrease their HIE severity
Birth asphyxia continues to be a significant cause of mortality and morbidity in neonates despite advances in neonatal medicine
Summary
Birth asphyxia and Hypoxic–ischemic encephalopathy (HIE) are significant causes of neonatal mortality and morbidity. Aim: To study serum electrolyte and calcium levels and their correlation with birth asphyxia and HIE severity. Results: It was observed that at Apgar score 1 and 5 minutes, with an increase in severity of birth asphyxia serum sodium and calcium levels decreased while potassium levels increased. A significant positive correlation was observed between serum sodium levels and Apgar score at 1 and 5 minutes. Serum calcium levels showed a significant positive correlation with 5 minutes Apgar score. Serum potassium levels at < 12 hours showed a significant negative correlation with 5 minutes Apgar score. The incidence of birth asphyxia ranges from 0.5– 2% of live births It is often associated with multiple pathophysiological consequences, which lead to multiorgan dysfunction. Decreased perfusion leads to devastating complications both immediate and long-term [2]
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