Study of urinary uric acid and creatinine ratio as a marker for perinatal asphyxia


  • Trinadh Gubbala Department of Paediatric, AJ Institute of Medical Science, Mangaluru, Karnataka, India
  • Shree Krishna G. N. Department of Paediatric, AJ Institute of Medical Science, Mangaluru, Karnataka, India



APGAR score, Creatinine, Perinatal asphyxia, Urinary uric acid


Background: Perinatal asphyxia refers to an impairment of the normal oxygenation during parturition and the ensuing adverse effects on the fetus/neonate.  In India, due to birth asphyxia, between 250,000 to 350,000 infants die each year, mostly within the first three days of life. Low APGAR score is commonly used to as a indicator of asphyxia in infants, but it may often be not available and may be reduced in premature infants. In present study we evaluated urinary uric acid and creatinine ratio as a marker for perinatal asphyxia, at our tertiary care hospital.

Methods: Present study was a observational, case-control study, conducted in department of paediatrics, in case group consisted of 40 full-term neonates who were hospitalized with the diagnosis of perinatal asphyxia. The control group consisted of 40 healthy full-term newborns.

Results: Male to female ratio was 1.5:1 in case group as compared to 1.22:1 in control group. Mean gestational age in case group was 286±10.32 days, while in control group it was 274±7.310 days. Mean birth weight was 2.72±0.51 kg & 2.88±0.49 kg in case & control group respectively. In 52.5 % neonates from case group, signs of intrapartum fetal distress were noted. A statistically significant difference (p<0.005) was noted in Apgar 5 min, Arterial blood pH, pO2 (mm Hg), pCO2 (mm Hg), Urinary uric acid (mg/dl) and Urinary uric acid/ creatinine ratio. Authors did not noted any significant difference in Urinary creatinine (mg/dl) values of cases and control group. Urinary UA/CR ratio is significantly higher in case group when compared with control group with t=11.19; P<0.001.

Conclusions: The ratio of urinary uric acid to creatinine helps in rapidly recognizing asphyxia and assessing its severity, so it can be a good, simple screening test for early assessment of neonatal asphyxia.


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