Study and correlation of the severity of birth asphyxia with serum levels of glucose, uric acid and electrolytes in the cord blood of asphyxiated neonates

Kavya M. Y., Sudha Rudrappa, Girish Gopal


Background: Perinatal asphyxia one of the most common primary cause of mortality and morbidity among neonates in India and is the commonest cause of stillbirths.

Methods: This prospective study was conducted for a period of 18 months which included cases (124) and controls (124) comprised of asphyxiated and non-asphyxiated neonates respectively.  The umbilical cord arterial blood was collected by double clamp technique and sent for analysis of electrolytes, uric acid and glucose.

Results: Umbilical arterial sodium, calcium and glucose concentration was significantly lower in cases as compared to Control and potassium, uric acid and creatinine concentration was found to be on the higher in the cases as compared to the controls, and the difference was statistically significant with p<0.001.

Conclusions: Metabolic abnormalities like hyponatremia, hypocalcaemia and hyperuricemia are significant risk factors for perinatal brain injury. Identification and treatment of such abnormalities results in improved outcome in affected neonates.


Calcium, Glucose, Hypoxic ischemic encephalopathy (HIE), Perinatal asphyxia, sodium, Uric acid

Full Text:



Lawn JE, Cousens S, Zupan J. Neonatal survival steering team. 4 million neonatal deaths: when? where? why? Lancet. 2005;365(9462):891-900.

Bryce J, Pinto C, Shibuya K, Black RE, WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147-52.

Klein JM, Zlatnik FJ, Hein HA. Multiorgan system failure from perinatal asphyxia. Iowa Perinat Lett. 2005;26(1):1-4.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatr. 2005;42(9):928-34.

Sergeyeva RA, Ismagilov MF. Cerebral palsy. Etiology and pathogenesis. Neurol Bull. 1998;6:1-2.

Chandra S, Ramji S, Thirupuram S. Perinatal asphyxia: Multivariate analysis of risk factors in hospital births. Indian Pediatr. 1997;34(3):206-12.

Porter KB, O'Brien WF, Benoit R. Comparison of cord purine metabolites to maternal and neonatal variables of hypoxia. Obstet Gynecol. 1992;79:394-7.

Palmer C, Vannucci RC, Towfighi J. Reduction of perinatal hypoxic- ischemic brain damage with allopurinol. Pediat Res. 1990;27:332-6.

Poulsen JP, Rognum TO, Oyasaeter. Changes in oxypurine concentration in vitreous humor of pigs during hypoxemia and postmortem. Pediatr Res. 1990;28:482-4.

Swanstrom S, Bratteby LE. Hypoxanthine as a test of perinatal hypoxia as compared to lactate, basedeficit, and pH. Pediatr Res. 1982;16:156-60.

Poulsen JP, Oyasaeter S, Sanderud J. Hypoxanthine, xanthine, and uric acid concentration in the cerebrospinal fluid, plasma, and urine of hypoxemic pigs. Pediatr Res. 1990;28:477-81.

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

Basu P, Som S, Das H, Choudhuri B. Electrolyte status in birth asphyxia. Indian J Pediatr. 2010;77(3):259-262.

Jajoo D, Kumar A, Shankar R, Bhargava V. Effect of birth asphyxia on serum calcium levels in neonates. Indian J Pediatr. 1995;62:455-9.

Onyiriuka AN. Prevalence of neonatal hypocalcaemia among full-term infants with severe birth asphyxia. Pacific J Med Sci. 2011;8(1):6-9.

Masood N, Muntiha S, Sharif M, Asghar RM. Correlation of serum electrolyte changes with severity of birth asphyxia in newborns. JRMC. 2016;20(1):27-9.