Association of Cord Blood Glucose, Sodium, Potassium, and Calcium Levels With Neonatal Birth Asphyxia: A Hospital-Based Study

Context Neonatal birth/perinatal asphyxia is a serious condition with the potential to cause damage to various tissues of the body especially the brain. Hypoxia can cause metabolic disturbances, which in turn can lead to imbalances in the levels of glucose, electrolytes, and calcium, which can further worsen the condition. Early detection of these biochemical derangements and immediate correction can prevent the complications and lifelong disabilities of birth asphyxia due to injury to vital organs particularly the brain. The aim is to assess any correlation between the cord blood glucose, electrolytes, and calcium levels and the severity of birth asphyxia. Methods and material In this study, 50 birth asphyxia neonates with birth weight >2.5 kg, and a 5-minute Apgar score ≤ 6 at birth with clinical evidence of asphyxia were compared with healthy neonates with birth weight > 2.5 kg, and a 5-minute Apgar score > 7. In all the cases and controls, cord blood glucose was estimated by glucose oxidase and peroxidase (GOD-POD) method, total calcium by Arsenazo method, and sodium and potassium were estimated by ion-selective Electrode (ISE) method using fully automated biochemistry analyzers. Results The mean cord blood concentrations of glucose, sodium, potassium, and calcium were significantly lower among birth asphyxia neonates in comparison with that of controls (p < 0.05). The correlation coefficient (r) for the study variables among cases indicates that there is a low to moderate positive correlation between the 5-minute Apgar score which is a measure of severity of birth asphyxia and cord blood concentrations of glucose, sodium, and calcium. Conclusion In our study, birth asphyxiated neonates were found to have statistically significant low levels of cord blood glucose and electrolytes like sodium and calcium except for potassium. There was a low to moderate positive correlation between cord blood glucose and electrolyte concentrations with the severity of birth asphyxia. Analysis of cord blood for these simple biochemical tests can help pediatricians in the active management of birth asphyxia cases.

[1]  C. Aundhakar,et al.  Electrolyte status and plasma glucose levels in birth asphyxia: A case–control study , 2021 .

[2]  S. Rudrappa,et al.  Study and correlate the severity of birth asphyxia with serum levels of glucose, uric acid and electrolytes in the cord blood of asphyxiated neonates , 2020, International Journal of Contemporary Pediatrics.

[3]  N. Mohanty,et al.  Clinico-Biochemical Correlation in Birth Asphyxia and Its Effects on Outcome , 2020, Cureus.

[4]  Ashekul Islam,et al.  Correlation of Apgar score with serum glucose, calcium and electrolytes on the asphyxiated neonates , 2019, International Journal of Scientific Reports.

[5]  Barzan Hasan,et al.  Electrolyte disturbance in asphyxiated neonates in maternity hospital in Erbil, Iraq , 2019, Medical Journal of Babylon.

[6]  R. ManjunathaBabu,et al.  A comparative study of serum electrolytes in newborns with birth asphyxia and non-asphyxiated newborns , 2018 .

[7]  P. Poudel,et al.  Prevalence of electrolyte disturbances in perinatal asphyxia: a prospective study , 2018, Italian Journal of Pediatrics.

[8]  R. Langade,et al.  Study of serum sodium, serum calcium and blood glucose level in neonates with birth asphyxia , 2017 .

[9]  V. Apgar A Proposal for a New Method of Evaluation of the Newborn Infant , 2015, Anesthesia and analgesia.

[10]  S. Rai,et al.  Effect of Birth Asphyxia on Serum Calcium and Glucose Level: A Prospective Study , 2015 .

[11]  H. Das,et al.  Electrolyte status in birth asphyxia , 2010, Indian journal of pediatrics.

[12]  J. Katz,et al.  Risk Factors for Neonatal Mortality Due to Birth Asphyxia in Southern Nepal: A Prospective, Community-Based Cohort Study , 2008, Pediatrics.

[13]  J. Spector,et al.  Preventing those so-called stillbirths. , 2008, Bulletin of the World Health Organization.

[14]  M. Parakh,et al.  Renal failure in asphyxiated neonates. , 2005, Indian pediatrics.

[15]  A. Bang,et al.  Management of Birth Asphyxia in Home Deliveries in Rural Gadchiroli: The Effect of Two Types of Birth Attendants and of Resuscitating with Mouth-to-Mouth, Tube-Mask or Bag–Mask , 2005, Journal of Perinatology.

[16]  S. Sabitha,et al.  Incidence and risk factors for neonatal hypoglycaemia in Kerala, India. , 2010, The Ceylon medical journal.

[17]  A. Sood,et al.  Biochemical abnormalities in neonatal seizures , 2003, Indian journal of pediatrics.

[18]  J. Lorenz,et al.  Assessing fluid and electrolyte status in the newborn. National Academy of Clinical Biochemistry. , 1997, Clinical chemistry.

[19]  Ashok Kumar,et al.  Effect of birth asphyxia on serum calcium levels in neonates , 1995, Indian journal of pediatrics.

[20]  J. Perlman,et al.  Acute systemic organ injury in term infants after asphyxia. , 1989, American journal of diseases of children.

[21]  J. Ellenberg,et al.  Obstetric complications as risk factors for cerebral palsy or seizure disorders. , 1984, JAMA.

[22]  H. Berendes,et al.  Apgar scores and outcome of the newborn. , 1966, Pediatric clinics of North America.

[23]  W. Payne,et al.  Blood Chemistry of Normal Full-term Infants in the First 48 Hours of Life , 1965, Archives of disease in childhood.