The value of urinary uric acid and creatinine ratio in neonatal asphyxia

Dr Nikhil Gupta,Dr Shashank Mishra,Dr Rashmi Katyal,Dr Alka Bhambri,Dr Shikha Saxena,Dr Vedika A Bhat

doi:10.17511/ijpr.2020.i08.06

Abstract

Objective: The value of urinary uric acid and creatinine ratio in neonatal asphyxia. Method: This was a prospective observational study conducted over one year, on 45 newborns admitted in NICU with perinatal asphyxia. Cord blood from the umbilical artery was sent for pH analysis and urinary uric acid and creatinine levels were estimated in spot urine samples. Results: The urinary uric acid and creatinine ratio had a positive correlation with low APGAR scores at the 1st and 5th minute. Also, urinary uric acid to creatinine ratios was significantly higher in infants with severe HIE (3.18±0.61) when compared with infants of moderate HIE (2.19±0.32). It showed a significant negative correlation with pH of cord blood in neonates with perinatal asphyxia. Conclusion: The urinary uric acid and creatinine ratio can be used as a supportive diagnostic test for early diagnosis of perinatal asphyxia.

Highlights

According to the latest estimates by the World Health Organization (WHO), approximately 4 million neonates die each year
Cord blood from the umbilical artery was sent for pH analysis and urinary uric acid and creatinine levels were estimated in spot urine samples
As per the National Neonatal Perinatal Database (NNPD), data collected from 17 tertiary neonatal intensive care units in India, perinatal asphyxia was responsible for 20% of all neonatal deaths

Summary

Introduction

According to the latest estimates by the World Health Organization (WHO), approximately 4 million neonates die each year. Out of which perinatal asphyxia and birth injuries together contribute to almost 29% of these deaths [1]. As per the National Neonatal Perinatal Database (NNPD), data collected from 17 tertiary neonatal intensive care units in India, perinatal asphyxia was responsible for 20% of all neonatal deaths. The manifestation of hypoxicischemic encephalopathy (HIE) was seen in approximately 1.5% of all babies. Perinatal asphyxia was the commonest cause of stillbirths, accounting for one-third of all such cases. Antepartum and intrapartum asphyxia contributes to 300,000 to 400,000 stillbirths. In India, 8.4% of inborn babies have 1minute APGAR scoreless than 7 and 1.4% suffer hypoxic-ischemic encephalopathy. Though there are many studies, data on early determination of the tissue damages due to birth asphyxia are still lacking [2]

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Discussion

Conclusion