Metabolic Derangement in Birth Asphyxia due to Cellular Injury with Reference to Mineral Metabolism in Different Stages of Hypoxic-ischemic Encephalopathy in Central India

Abstract

ABSTRACT Introduction Perinatal asphyxia is one of the major causes of neonatal mortality and long-term morbidity. Although neonates with severe birth asphyxia are known to be at increased risk of early-onset hypocalcemia, the magnitude of the problem is not well documented. Magnesium plays a role in neuroprotection for neonates with hypoxic-ischemic encephalopathy (HIE). The objective of this study was to determine the prevalence of early-onset hypocalcemia and hypomagnesemia in severely asphyxiated neonates. Materials and methods This study was carried out on 75 newborns distributed as group I (50 asphyxiated neonates) and group II (25 healthy neonates). Serum calcium and serum magnesium was estimated within 24 hours after birth, followed by third and fifth day postbirth. Results Maximum number of cases (81.3%) were born by vaginal delivery. The mean value of serum calcium on days 1, 3, and 5 for group I was 7.004 ± 0.691, 7.482 ± 0.760, 8.184 ± 0.811 in contrast to group II: 8.788 ± 0.399, 9.476 ± 0.250, 9.992 ± 0.277 respectively. Whereas the mean value of serum magnesium for group I is reported as 1.545 ± 0.045, 1.496 ± 0.067, 1.556 ± 0.057 on days 1, 3, and 5, while that of group II was 1.518 ± 0.053, 1.597 ± 0.049, 1.66 ± 0.065 respectively. On HIE stage-wise comparison, abnormal calcium metabolism percentage increases with severity of asphyxia (46.6% abnormal in stage I, while 71.4% abnormal in stage III). Abnormal magnesium metabolism percentage also increases with severity of asphyxia (26.6% abnormal in stage I, while 71.4% abnormal in stage III) and this abnormality persists up to fifth day in stage III. Conclusion Birth asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. Serum calcium and magnesium level plays exceptionally imperative role for escaping HIE and other induced complications. How to cite this article Bhimte B, Vamne A. Metabolic Derangement in Birth Asphyxia due to Cellular Injury with Reference to Mineral Metabolism in Different Stages of Hypoxic-ischemic Encephalopathy in Central India. Indian J Med Biochem 2017;21(2):86-90.