Electrolyte abnormalities in asphyxiated newborns

Satheesh Kumar D., Thenmozhi M., Kumar .


Background: Perinatal asphyxia is the most common cause of neonatal morbidity and mortality in worldwide. It accounts for 23% of all neonatal deaths. Electrolyte abnormalities are more common in the immediate post asphyxiated period and influence neonatal the outcome effectively. Aim of this study was to measure the serum sodium, potassium and calcium levels in immediate postnatal period of asphyxiated newborns and assess the correlation with different degree of birth asphyxia.

Methods: The serum sodium, potassium and calcium levels were measured in asphyxiated newborns in the early post-natal period. Both intramural and extramural newborns were included irrespective of their mode of delivery but according to the Apgar score. The measured electrolyte values were compared with the different severity of asphyxia. Results: Out of 100 newborns 53 had hyponatremia, 10 had hyperkalemia and 3 had hypocalcemia. The serum sodium and potassium levels showed significant P value (<0.00) with the different degree of both asphyxia but calcium levels were not significant (p valve = 0.06). There was a negative linear correlation with sodium and calcium levels and positive correlation with the serum potassium levels.

Conclusions: Hyponatremia was significant in all stages of birth asphyxia, hyperkalemia was significant with increased severity of birth asphyxia and hypocalcemia was only weakly significant even in severe birth asphyxia.


HIE, hypocalcemia, Hyponatremia, Hyperkalemia

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Birth Asphyxia - Summary of the previous meeting and protocol overview. Available at

Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147-52.

Antonucci R, Porcilla A, Pilloni MD. Perinatal asphyxia in the term newborn. J Pediatr Individual Med. 2014;3(2):25-8.

Lawn JE, Wilczynsha-ktende K, Cousens SN. Estimating the causes of four million deaths in the year 2000. Int J Epidemiol. 2006;35(3):718-9.

NNPD network. National Neonatal Perinatal Database -Report for the year2002-2003. NNF NNPD network. NewDelhi: 2005.

Lawn JE, Manandhan A, Haws RA, Darmastadt G. Reducing one million child deaths from birth asphyxia: survey of health system gaps and priorities. Health Res Policy Sys. 2007;5(1):4.

Ress L, Brook CGD, Shaw JCL, Forsling ML. Hyponatraemia in the first week of life in preterm infants (part I arginine vasopressin secretion). Arch Dis Child. 1984;59:414-22.

Adrogue HJ, Madias NE. Changes in plasma potassium concentration during acute acid-base disturbances. Am J Med. 1984;71:456-65.

Basu P, Sam S, Das H. Electrolytes status in birth asphyxia. Indian J Pediatr. 2010;77:259-62.

Jajoo D, Kumar A, Shankar R, Bhargava V. Effect of birth asphyxia on serum calcium levels in Neonates. Indian J Pediatr. 1995;62:455-9.

Tsang RC, Light IJ, Sutherland JM, Kleinman L. Possible pathogenetic factors in neonatal hypocalcemia of prematurity. J Pediatr. 1973;82:423-9.

Tsang RC, Chan I, Hayes W, Atkinson W, Atherton H, Edwards N. Neonatal hypocalcemia in infants with birth asphyxia. J Pediatr. 1974;84:428-33.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatr. 2005;42:928-34.

Lackmann GM, Mader R, Tollner U. Serum potassium level in healthy neonates and infants with asphyxia in the first 144 hours of life. Klinische Padiatrie. 1991;203(5):399-402.

Kecskes Z, Healy G, Jensen A. Fluid restriction for term infants with hypoxic-ischaemic encephalopathy following perinatal asphyxia. Cochrane Database Sys Rev. 2005;3:CD004337.