A study of urinary uric acid to creatinine ratio as a biochemical marker of perinatal asphyxia


  • Vaishali R. Chanpura Department of Paediatrics, Medical College and SSG Hospital, Vadodara, Gujarat, India
  • Mayur G. Kacha Department of Paediatrics, Medical College and SSG Hospital, Vadodara, Gujarat, India




Urinary uric acid/creatinine ratio, Hypoxic ischemic encephalopathy, Perinatal asphyxia


Background: Perinatal asphyxia remains an important cause of neonatal mortality, morbidity and sequelae especially in developing countries. Prevalence of perinatal asphyxia is 1 to 6 per 1000 live births while incidence of hypoxic-ischemic injury is 0.3 to 2 per 1000 term infants. There was a need to identify neonates with asphyxia at risk for hypoxic ischemic encephalopathy and multi-organ dysfunction using simple bedside tests. The objectives of the study were to evaluate the efficacy of uric acid to creatinine (UA/Cr) ratio in early spot urine samples as a diagnostic tool for perinatal asphyxia and to assess the relationship between urinary UA/Cr ratio and severity of HIE.

Methods: This study was conducted on 49 neonates having asphyxia (cases) and 49 neonates without asphyxia (controls) born at a tertiary care hospital over 12 months. Spot urine samples were collected within 24 hours of life and sent for analysis. A UA/Cr ratio of >2.51 was taken as cut-off value.

Results: The urinary UA/Cr ratio was found to be higher in asphyxiated infants (2.88±1.01) as compared to the control group (1.72±0.7, p<0.001). UUA/Cr ratio was significantly higher in infants with HIE stage 3 (3.65±1.4) as compared to infants with HIE stage 2 (2.62±0.76) and HIE stage 1 (2.71±0.4) (p<0.009). The cut-off UUA/Cr value of >2.51 has 71.43% sensitivity and 93.88% specificity.

Conclusions: The UUA/Cr ratio is a simple and reliable screening test for early diagnosis and assessment of perinatal asphyxia. 

Author Biographies

Vaishali R. Chanpura, Department of Paediatrics, Medical College and SSG Hospital, Vadodara, Gujarat, India

Assistant Professor Department of Paediatrics Medical College Vadodara

Mayur G. Kacha, Department of Paediatrics, Medical College and SSG Hospital, Vadodara, Gujarat, India

Resident Doctor, Department of pediatrics, medical College, Vadodara


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Original Research Articles