DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201500

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

Trinadh Gubbala, Shree Krishna G. N.

Abstract


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.


Keywords


APGAR score, Creatinine, Perinatal asphyxia, Urinary uric acid

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References


Lawn JE, Cousens S, Zupan J. Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? Lancet. 2005;365(9462):891-900.

Network NN. National Neonatal-Perinatal Database (Report 2002–2003). New Delhi, India: Department of Pediatrics, All India Institute of Medical Sciences. 2005. Available at: https://www.newbornwhocc.org/pdf/nnpd_report_2002-03.PDF

Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM et al., Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet. 2005;365(9460):663-70.

Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, Donovan EF, Fanaroff AA et al., Wholebody hypothermia for neonates with hypoxic-ischemic encephalopathy. N Eng J Med. 2005;353(15):1574-84.

American Academy of Pediatrics. The APGAR score. Adv Neonatal Care. 2006;6(4):220-3.

Bracci R, Perrone S, G. Buonocore G, The timing of neonatal brain damage. Neonatology. 2006;90(3):145-55.

Odd DE, Whitelaw A, Gunnell D, Lewis G. The association between birth condition and neuropsychological functioning and educational attainment at school age: a cohort study. Arch Dis Child. 2011;96:30-7.

Chen HJ, Yau KI, Tsai KS. Urinary uric acid/creatinine ratio as an additional marker of perinatal asphyxia. J Formos Med. Assoc. 2000;99(10):771-4.

Bahubali DG, Bhat VB, Ramachandra R, Adhisivam B, Rojo J, Prasad P, et al. Biochemical marker as predictor of outcome in perinatal asphyxia. Cur Ped Res. 2013;17(2).

Vandana V, Amit V, Meena V, Anuradha B, Vivek B, Deepak V, et al. Study of basic biochemical and haematological parameters in perinatal asphyxia and its correlation with Hypoxic ischemic encephalopathy staging. J Adv Res Bio Sci. 2011;3(2):79-85.

Banupriya C, Doureradjou P, Mondal N, Vishnu B, Koner BC. Can urinary excretion rate of malondialdehyde, uric acid and protein predict the severity and impending death in perinatal asphyxia?. Clin Biochem. 2008;41(12):968-73.

Bhongir AV, Yakama AV, Saha S, Radia SB, Pabbati J. The Urinary Uric Acid/Creatinine Ratio is An Adjuvant Marker for Perinatal Asphyxia. Eur J Pharm Med Res. 2015;2(5):520-8.