Serum calcium and glucose level in asphyxiated neonates: a prospective study

Abstract

Background: Birth asphyxia is the primary cause of both mortality and death in newborns. Neonates that experience birth asphyxia are more likely to develop hypocalcemia and hypoglycemia. The primary objective of this study was to assess the calcium and glucose in newborns who had asphyxia and compare with the hypoxic-ischemic encephalopathy (HIE) severity. Methods: This prospective observational study conducted on 75 asphyxiated neonates admitted to NICU. The serum calcium, ionized calcium and glucose level were measured using standard biochemical methods. The severity of HIE was assessed using the Sarnat and Sarnat staging system. The calcium and glucose level were compared across different stages of HIE using one-way ANOVA. Results: The mean total calcium level was 7.87±1.87 mg/dl, mean ionized calcium level was 3.27±0.76 mg/dl and mean serum glucose level was 44.43±6.5 mg/dl respectively. Out of 75 neonates, majority 32 (42.7%) were in were in HIE stage II moderate risk. There was a significant decline in calcium level among the neonate in HIE stage III severe risk when compared to HIE stage II (3.65±0.97 vs 4.05±1.06) and HIE stage I (3.65±0.97 vs 5.76±1.32). The mean serum glucose level was significantly (p=0.001) lower in HIE stage III severe risk when compared to HIE stage II (38.12±4.65 vs 44.76±5.45) and HIE stage I (38.12±4.65 vs 50.43±6.28). Conclusions: The ionic calcium and glucose levels were decreased in asphyxiated neonates and early intervention is required to reduce the neonatal mortality.