Urinary Uric Acid to Urinary Creatinine Ratio- A Very Promising Biochemical Marker for Perinatal Asphyxia!!!

Abstract

Background: Perinatal asphyxia is one of the major problems of neonates and there exists a significant contribution to the neonatal morbidity and by this entity. It is recognized as a common and critical cause of preventable cerebral injury. Predicting the outcome of perinatal asphyxia is critical but dreadful. The Apgar score has a limited role in predicting the immediate outcome, such as HIE, and the long-term neurological sequelae observational error may occur in APGAR. However, the biochemical parameters can be relied on. The diagnosis and grading of asphyxia can be difficult especially if relevant information at the time of delivery is not available  The purpose of this study was to evaluate the urinary uric acid/creatinine ratio (UA/Cr) as a non-invasive marker for perinatal asphyxia and to correlate its absolute value to the degree of perinatal asphyxia. Objectives: To validate Urinary Uric acid to Urinary Creatinine ratio as a marker of perinatal asphyxia To validate Urinary Uric Acid to Urinary Creatinine ratio as a marker of degree of perinatal asphyxia To define cut off value of Urinary Uric acid to Urinary Creatinine ratio to diagnose perinatal asphyxia Methods: Between November 2017 and May 2019, 42 asphyxiated and 42 non-asphyxiated newborns were included in this prospective case control research done in the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent in for uric acid and creatinine determination. The findings were documented, and statistical analysis was carried out. Results: Urinary uric acid to creatinine ratio is a non-invasive, early, and simple biochemical marker of birth hypoxia that biochemically supports severity grading and clinical diagnosis by APGAR score. Conclusions: The urinary uric acid and creatinine ratio allows for the immediate and early detection of asphyxial injury, as well as the assessment of its severity and potential for short-term morbidity or mortality.