Abstract
Background: Neonates with perinatal asphyxia are prone to development of hypoxic ischemic-encephalopahty (HIE). There are no reliable methods for prediction of HIE in these neonates. Objectives: To determine urinary lactate to creatinine ratio in neonates with perinatal asphyxia and its correlation with severity of hypoxic ischemic encephalopathy. Material and Methods: A prospective study was carried out at neonatal intensive care unit (NICU) at Department of Pediatrics, MLB Medical College Jhansi. 50 neonates born at > 36 weeks gestation with perinatal asphyxia, admitted in neonatal intensive care unit were taken as cases and 50 normal newborns with gestational age > 36 week included as control. We measured the ratio of lactate to creatinine in urine sample by colometric technique within 24 hr after birth both in cases and controls. All newborns were followed for 7 days during their stay in hospital for development of HIE. The results were correlated with the subsequent presence or absence of HIE. Results: The study revealed that mean urinary lactate to creatinine ratio during first 24 hours of life was higher in asphyxiated neonates than control group(5.35±4.59 vs 0.18±.07), the difference was found to be statistically highly significant (z=7.693; p=<0.0001). The grade of HIE correlated with the greater urinary lactate to creatinine ratio among cases and was significant (p=<0.0001). Conclusion: The urinary lactate to creatinine (Urinary L/C) ratio in newborn infants with asphyxia is significantly increased early in course of the disease which can be used as useful parameter for predicting the development of hypoxic ischemic encephalopathy.
Highlights
Perinatal asphyxia is one of the most important causes of neonatal mortality and subsequent neurological disability among the infants who survive [1,2,3]
Gestational age, and sex were similar among the normal infants and the infants with asphyxia that developed hypoxic– ischemic encephalopathy (Table 1)
Urinary L/C ratio of control group was compared with Urinary L/C ratio of cases with hypoxic ischemic-encephalopahty (HIE) 1, HIE 2 and HIE 3 respectively and the difference was found to be highly significant (p
Summary
Perinatal asphyxia is one of the most important causes of neonatal mortality and subsequent neurological disability among the infants who survive [1,2,3]. It occurs in 2.9 to 9 per 1000 term newborns. Objectives: To determine urinary lactate to creatinine ratio in neonates with perinatal asphyxia and its correlation with severity of hypoxic ischemic encephalopathy. Conclusion: The urinary lactate to creatinine (Urinary L/C) ratio in newborn infants with asphyxia is significantly increased early in course of the disease which can be used as useful parameter for predicting the development of hypoxic ischemic encephalopathy
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