Electrolyte abnormalities in patients with perinatal asphyxia

M. D. Shamsuzzaman Prodhan; Abu Zafar M. Azad; Sangida Shormin; M. Fazlul Kader; M. Monwarul Islam; Mrinal Kanti Das; Shah M. Moazzem Hossain

doi:10.18203/2349-3291.ijcp20223331

Authors

M. D. Shamsuzzaman Prodhan Department of Paediatrics, Rangpur Medical College and Hospital, Rangpur, Bangladesh
Abu Zafar M. Azad Department of Paediatrics, Rangpur Medical College and Hospital, Rangpur, Bangladesh
Sangida Shormin Department of Paediatrics, Rangpur Medical College and Hospital, Rangpur, Bangladesh
M. Fazlul Kader Department of Pediatrics, Rajshahi Medical College, Rajshahi, Bangladesh
M. Monwarul Islam Department of Paediatrics, Panchagor Sadar Hospital, Panchagor, Bangladesh
Mrinal Kanti Das Department of Pediatrics, Rajshahi Medical College, Rajshahi, Bangladesh
Shah M. Moazzem Hossain Department of Paediatrics, M. Abdur Rahim Medical College Hospital, Dinajpur, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20223331

Keywords:

Asphyxia, Perinatal, Electrolyte, Hyponatremia, Hyperkalemia, Neonates

Abstract

Background: Perinatal hypoxia is still a major cause of death and disability in developing countries. The infant mortality rate fell from 92 per 1000 live births in 1991 to 43 per 1000 live births in 2011. The aim of the study was to study the electrolyte abnormalities in perinatal asphyxia cases.

Methods: This cross-sectional descriptive study was conducted at the Department of Obstetrics and Pediatrics, Rangpur Medical College and Hospital, Rangpur, Bangladesh. The study duration was 2 years, from January 2012 to December 2013. The study was conducted with a total of 120 neonates admitted in the neonatal ward of the study hospital, among which, 60 neonates who had perinatal asphyxia were selected for the case group, and the remaining 60 were age and gender-matched control group participants.

Results: In 70% of cases, the mother was Primipara. Among the neonates, 61.67% were male, and 38.33% were female. Only 33% of the case neonates had received regular antenatal check-ups, while 55% had irregular check-ups, and 11.67% had no antenatal checkups. According to the grading of asphyxia, 51.67% of neonates had moderate asphyxia, 20% had mild asphyxia, and 28.33% had severe asphyxia. The comparison of mean values between the case, and control groups showed that both blood urea, and serum creatinine levels were significantly higher among the case group participants, compared to control group values. The mean serum sodium value in mild, moderate, and severe asphyxia were 135.33, 123.42, and 121.53 mmol/l respectively. Mean serum potassium values were 4.11, 4.86, and 5.51 mmol/l respectively. Mean serum creatinine 0.72, 1.00, and 1.83 mg/dl respectively. Mean blood urea levels were 36.17, 58.97, and 88.06 mg/dl respectively. A significant difference was observed between the mean values of serum electrolytes and patients’ asphyxia grade.

Conclusions: The study findings can conclude that electrolyte abnormalities are common among perinatal asphyxia patients, and babies with perinatal asphyxia developed hyponatremia, and hyperkalemia at a higher frequency, and significant raises of serum creatinine, and blood urea was also observed, which was proportionate to the severity of asphyxia.

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References

Shirin N, Nahar N, Mollah AH. Risk factor, and short term outcome of birth asphyxiated babies in Dhaka medical college hospital, Bangladesh J Child Health. 2009;33(3):83-9.

The State of the World’s Children 2009. Unicef.org. [cited 2022 Dec 20]. Available at: https://www.unicef.org/reports/state-worlds-children-2009. Accessed on 3 June 2022.

Recognition, and Response to Birth Asphyxia during Delivery at Home in Matlab, Bangladesh. ResearchGate; 2022. Available at: https://www. researchgate.net/profile/Jasmin-Khan-4/publication/ 285581581_Recognition_and_Response_to_Birth_Asphyxia_during_Delivery_at_Home_in_Matlab_Bangladesh/links/5665520108ae15e74633c77a/Recognition-and-Response-to-Birth-Asphyxia-during-Delivery-at-Home-in-Matlab-Bangladesh.pdf. Accessed on 20 December 2022.

VanderEnde KE, Moran AC, Leasure K, Day LT, Afsana K, Kalim N, et al. Recognition of, and response to neonatal intrapartum-related complications in home-birth settings in Bangladesh. Journal of health, population, and nutrition. 2014;32(3):503.

Chowdhury MA, Banu K, Rahman M, Rahman M. Birth asphyxia-a prospective study in Dhaka Shishu Hospital. DS (Child) HJ. 1996;12:18-22.

Rees L, Brook CG, Shaw JC, Forsling ML. Hyponatraemia in the first week of life in preterm infants. Part I. Arginine vasopressin secretion. Archives of disease in childhood. 1984;59(5):414-22.

Adrogué HJ, Madias NE. Changes in plasma potassium concentration during acute acid-base disturbances. The American journal of medicine. 1981;71(3):456-67.

Hossain MM, Shirin M, Mamun MA, Chowdhury NA, Hasan MQ, Afroza S. Electrolyte abnormalities in neonates admitted in Intensive Care Unit. Bangladesh J Child Health. 2004;28(1):13-7.

Aggarwal R, Deorari AK, Paul VK. Fluid, and electrolyte management in term, and preterm neonates. The Indian Journal of Pediatrics. 2001;68(12):1139-42.

Perlman JM, Tack ED, Martin T, Shackelford G, Amon E. Acute systemic organ injury in term infants after asphyxia. American Journal of Diseases of Children. 1989;143(5):617-20.

Costello AM, Manandhar DS. Perinatal asphyxia in less developed countries. Archives of Disease in Childhood Fetal, and Neonatal Edition. 1994;71(1):F1.

Oh W. Renal function, and fluid therapy in high risk infants. Neonatology. 1988;53(4):230-6.

Basu P, Das H, Choudhuri N. Electrolyte status in birth asphyxia. The Indian Journal of Pediatrics. 2010;77(3):259-62.

Bhuiyan SJ. Incidence, risk factors, and immediate outcome of Asphyxia Neonatorum in hospitalized neonates: Dept. of Paed IPGMR [Dessertation]. Dhaka: BCPS; 1996.

Cotten CM, Shankaran S. Hypothermia for hypoxic–ischemic encephalopathy. Expert review of Obstetrics and Gynecology. 2010;5(2):227-39.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian pediatrics. 2005;42(9):928.

Mangi ZA, Bouk GR, Junejo B, Junejo A, Shaikh SH, Jamro S. Birth asphyxia relationship between hypoxic ischemic encephalopathy grading, and development of acute renal failure in indoor term neonates at chandka medical college children hospital Larkana. Medical channel. 2009;15:148-52.

Roy B, Mondal G. Study of Renal Profile in Babies with Perinatal Asphyxia in a Tertiary Care Hospital: A Prospective Case Control Study. Journal of Nepal Paediatric Society. 2013;33(3).

Singhi S. Hyponatremia in hospitalized critically ill children: current concepts. The Indian Journal of Pediatrics. 2004;71(9):803-7.