Serum calcium and glucose level in asphyxiated neonates: a prospective study

Authors

  • Darla Sri Sai Lahari Department of Paediatrics, Al -Ameen Medical College and Hospital, Vijayapura, Karnataka, India
  • Nazeer Ahmad Jeergal Department of Paediatrics, Al -Ameen Medical College and Hospital, Vijayapura, Karnataka, India
  • A. N. Thobbi Department of Paediatrics, Al -Ameen Medical College and Hospital, Vijayapura, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242334

Keywords:

Birth asphyxia, Electrolytes, Ionized calcium, Glucose, HIE

Abstract

Background: Birth asphyxia is the primary cause of both mortality and death in newborns. Neonates that experience birth asphyxia are more likely to develop hypocalcemia and hypoglycemia. The primary objective of this study was to assess the calcium and glucose in newborns who had asphyxia and compare with the hypoxic-ischemic encephalopathy (HIE) severity.

Methods: This prospective observational study conducted on 75 asphyxiated neonates admitted to NICU. The serum calcium, ionized calcium and glucose level were measured using standard biochemical methods. The severity of HIE was assessed using the Sarnat and Sarnat staging system. The calcium and glucose level were compared across different stages of HIE using one-way ANOVA.

Results: The mean total calcium level was 7.87±1.87 mg/dl, mean ionized calcium level was 3.27±0.76 mg/dl and mean serum glucose level was 44.43±6.5 mg/dl respectively. Out of 75 neonates, majority 32 (42.7%) were in were in HIE stage II moderate risk. There was a significant decline in calcium level among the neonate in HIE stage III severe risk when compared to HIE stage II (3.65±0.97 vs 4.05±1.06) and HIE stage I (3.65±0.97 vs 5.76±1.32). The mean serum glucose level was significantly (p=0.001) lower in HIE stage III severe risk when compared to HIE stage II (38.12±4.65 vs 44.76±5.45) and HIE stage I (38.12±4.65 vs 50.43±6.28).

Conclusions: The ionic calcium and glucose levels were decreased in asphyxiated neonates and early intervention is required to reduce the neonatal mortality. 

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References

World Health Organization. Perinatal asphyxia. Available at: https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/newborn-health/perinatal-asphyxia. Accessed on 12 June 2024.

Widmer M, Piaggio G, Nguyen TMH, Osoti A, Owa OO, Misra S, et al. Heat-Stable Carbetocin versus Oxytocin to Prevent Hemorrhage after Vaginal Birth. N Engl J Med. 2018;379(8):743-52.

Chiabi A, Pisoh WD, Tsayim FT, Samje M, Feuldi E, Sunjo F, et al. Risk Factors of Perinatal Asphyxia and Neonatal Outcome. Pediatr Oncall. 2021;18(4):107-13

Jain S, Samrina J, Samanta I. Newborn care in Northern India: A study of regional and seasonal peculiarities for desired professionalism and definitive practices. J Fam Med Prim Care. 2023;12(2):227-35.

Neonatal Encephalopathy and Neurologic Outcome, Second Edition. Pediatrics. 2014;133(5):e1482-8.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696-705.

Basu P, Som S, Das H, Choudhuri N. Electrolyte status in birth asphyxia. Indian J Pediatr. 2010;77(3):259-62.

Rai S, Kaur Bhatiyani K, Kaur S. Effect of Birth Asphyxia on Serum Calcium and Glucose Level: A Prospective Study. Int J Sci Study. 2015;3(7):3-6.

Perlman JM. Markers of Asphyxia and Neonatal Brain Injury. N Engl J Med. 1999;341(5):364-65.

Douglas-Escobar M, Weiss MD. Hypoxic-Ischemic Encephalopathy A Review for the Clinician. JAMA Pediatr. 2015;169(4):397-403.

Bahatkar K, Aundhakar C. Electrolyte status and plasma glucose levels in birth asphyxia: A case–control study. J Med Sci. 2021;41(1):17-21.

Patidar A, Resident S, Kumar V, Senior G. An observational study to determine relation between hypocalcemia and birthasphyxia. J Cardiovascular Dis Res. 2021;12 (6):1719-24.

Chalak LF, Pruszynski JE, Spong CY. Sex Vulnerabilities to Hypoxia-Ischemia at Birth. JAMA Netw Open. 2023;6(8):e2326542.

Onyiriuka AN. Prevalence of neonatal hypocalcaemia among full-term infants with severe birth asphyxia. Pacific J Med Sci. 2011;3-12.

Singh BB, Chandwani C, Mahajan K, Singh G. Total Serum Calcium and Ionic Calcium Levels in Birth Asphyxia: A Prospective Study. J Clin Diagnostic Res. 2020;14(3):SC01-2.

Jain A, Agarwal R, Sankar MJ, Deorari A, Paul VK. Hypocalcemia in the Newborn. Indian J Pediatr. 2010;77(10):1123-28.

Acharya A, Swain B, Pradhan S, Jena PK, Mohakud NK, Swain A, et al. Clinico-Biochemical Correlation in Birth Asphyxia and Its Effects on Outcome. Cureus. 2020;12(11):e11407.

Saha D, Ali MA, Haque MA, Ahmed MS, Sutradhar PK, Latif T, et al. Association of hypoglycemia, hypocalcemia and hypomagnesemia in neonates with perinatal asphyxia. Mymensingh Med J. 2015;24(2):244-50.

Stanley CA, Rozance PJ, Thornton PS, De Leon DD, Harris D, Haymond MW, et al. Re-Evaluating “Transitional Neonatal Hypoglycemia”: Mechanism and Implications for Management. J Pediatr. 2015;166(6):1520-5.

Lee JK, Poretti A, Perin J, Huisman TAGM, Parkinson C, Chavez-Valdez R, et al. Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury. Dev Neurosci. 2017;39(1-4):248-56.

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Published

2024-08-27

How to Cite

Lahari, D. S. S., Jeergal, N. A., & Thobbi, A. N. (2024). Serum calcium and glucose level in asphyxiated neonates: a prospective study. International Journal of Contemporary Pediatrics, 11(9), 1228–1232. https://doi.org/10.18203/2349-3291.ijcp20242334

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Original Research Articles